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Sample records for compliance medication understanding

  1. The impact of an automated dose-dispensing scheme on user compliance, medication understanding, and medication stockpiles

    DEFF Research Database (Denmark)

    Larsen, Anna Bira; Haugbølle, Lotte Stig

    2007-01-01

    the assumed user benefits. Neither Danish nor international studies dealt with users' perspective on ADD in general or with respect to the pinpointed benefits, and thus exploration was needed. OBJECTIVES: The objective of this article is to respond to the following research question: How does ADD affect users......' handling and consumption of medication in terms of compliance behavior, and how does the assumption of user benefits made by health professionals and legislators measure up to users' experiences with ADD? METHODS: The results built on a secondary analysis of 9 qualitative interviews with a varied selection...... understanding, nor does it automatically eliminate stockpiles of old medication in users' homes. The gap between the perspectives of users and health professionals makes a compelling case for considering users' voices in the development and implementation of future health technologies....

  2. [Insufficient medication compliance in Parkinson's disease].

    Science.gov (United States)

    Aerts, Marjolein B; van der Eijk, Martijn; Kramers, Kees; Bloem, Bastiaan R

    2011-01-01

    Medication compliance is generally suboptimal, particularly in patients with complex polypharmacy. This generic treatment problem is described here for Parkinson's disease (PD). We would expect patients with PD to have good medication compliance, since missed doses immediately result in worsening of symptoms. However, recent research has revealed that PD patients demonstrate poor medication compliance. Poor medication compliance is particularly undesirable for patients with PD because regular intake of medication is required for optimal treatment effect. Possible ways of improving medication compliance are pharmacotherapeutic measures and behavioural interventions. Modern methods of communication (text message reminders) and 'smart' pill dispensers may be beneficial, but the advantages of such interventions have not yet been scientifically studied.

  3. [Insufficient medication compliance in Parkinson's disease

    NARCIS (Netherlands)

    Aerts, M.B.; Eijk, M. van der; Kramers, C.; Bloem, B.R.

    2011-01-01

    Medication compliance is generally suboptimal, particularly in patients with complex polypharmacy. This generic treatment problem is described here for Parkinson's disease (PD). We would expect patients with PD to have good medication compliance, since missed doses immediately result in worsening of

  4. Role of illness perceptions and medication beliefs on medication compliance of elderly hypertensive cohorts.

    Science.gov (United States)

    Rajpura, Jigar R; Nayak, Rajesh

    2014-02-01

    Poor compliance with antihypertensive medications is one possible reason why its success in clinical trials has not been translated into everyday practice. In addition, medication noncompliance in elderly leads to increased hospitalizations, physician visits, and higher health care costs. The study assessed influence of illness perceptions and medications beliefs on medication compliance of elderly hypertensive cohorts. A cross-sectional survey research design, utilizing self-administered health surveys, was adapted to address key study objectives. Conceptualized associations among the study variables were explored to assess their individual as well as their collective impact on the medication compliance. A total of 78 (66%) study samples were found to be noncompliant with their medications. Analysis revealed that perceptions about illness and beliefs about medication jointly played a significant role in the prediction of medication compliance (F = 5.966, P compliance building in elderly populations having hypertension by incorporating the value and importance of patient perceptions of illness and medications in order to achieve desired patient outcomes.

  5. Identification of factors involved in medication compliance: incorrect inhaler technique of asthma treatment leads to poor compliance

    Directory of Open Access Journals (Sweden)

    Darbà J

    2016-02-01

    Full Text Available Josep Darbà,1 Gabriela Ramírez,2 Antoni Sicras,3 Laura García-Bujalance,4 Saku Torvinen,5 Rainel Sánchez-de la Rosa6 1Department of Economics, Universitat de Barcelona, 2BCN Health Economics & Outcomes Research S.L., 3Department of Planning, Badalona Serveis Assistencials S.A., Barcelona, 4Market Access Department, Teva Pharmaceutical, Madrid, Spain; 5Market Access Department, Teva Pharmaceuticals Europe BV, Amsterdam, the Netherlands; 6Medical Department, Teva Pharmaceutical, Madrid, Spain Objective: To identify the impact of delivery device of inhaled corticosteroids and long-acting β2-agonist (ICS/LABA on asthma medication compliance, and investigate other factors associated with compliance. Materials and methods: We conducted a retrospective and multicenter study based on a review of medical registries of asthmatic patients treated with ICS/LABA combinations (n=2,213 whose medical devices were either dry powder inhalers (DPIs, such as Accuhaler®, Turbuhaler®, and NEXThaler® or pressurized metered-dose inhalers (pMDI. Medication compliance included persistence outcomes through 18 months and medication possession ratios. Data on potential confounders of treatment compliance such as asthma exacerbations, comorbidities, demographic characteristics, and health care resource utilization were also explored. Results: The probability of asthma medication compliance in case of DPIs was lower compared to pMDIs, which suggests that inhaler devices influence inhalation therapies. There were additional confounding factors that were considered as explanatory variables of compliance. A worse measure of airflow obstruction (forced expiration volume in 1 second, comorbidities and general practitioner (GP consultations more than once per month decreased the probability of compliance. Within comorbidities, alcoholism was positively associated with compliance. Patients of 29–39, 40–50, and 51–61 age groups or suffering from more than two

  6. Understanding and managing compliance in the nature conservation context.

    Science.gov (United States)

    Arias, Adrian

    2015-04-15

    Nature conservation relies largely on peoples' rule adherence. However, noncompliance in the conservation context is common: it is one of the largest illegal activities in the world, degrading societies, economies and the environment. Understanding and managing compliance is key for ensuring effective conservation, nevertheless crucial concepts and tools are scattered in a wide array of literature. Here I review and integrate these concepts and tools in an effort to guide compliance management in the conservation context. First, I address the understanding of compliance by breaking it down into five key questions: who?, what?, when?, where? and why?. A special focus is given to 'why?' because the answer to this question explains the reasons for compliance and noncompliance, providing critical information for management interventions. Second, I review compliance management strategies, from voluntary compliance to coerced compliance. Finally, I suggest a system, initially proposed for tax compliance, to balance these multiple compliance management strategies. This paper differs from others by providing a broad yet practical scope on theory and tools for understanding and managing compliance in the nature conservation context. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Compliance to medication among hypertensive patients in Murtala ...

    African Journals Online (AJOL)

    Compliance to medication among hypertensive patients in Murtala Mohammed Specialist Hospital, Kano, Nigeria. M Kabir, Z Iliyasu, LS Abubakar, M Jibril. Abstract. Background: Non-compliance to blood pressure-lowering medication is a major reason for poor control of hypertension worldwide. We assessed the level of ...

  8. Improving admission medication reconciliation compliance using the electronic tool in admitted medical patients

    Science.gov (United States)

    Taha, Haytham; abdulhay, dana; Luqman, Neama; Ellahham, Samer

    2016-01-01

    Sheikh Khalifa Medical City (SKMC) in Abu Dhabi is the main tertiary care referral hospital in the United Arab Emirates (UAE) with 560 bed capacity that is fully occupied most of the time. SKMC senior management has made a commitment to make quality and patient safety a top priority. Our governing body Abu Dhabi Health Services Company has identified medication reconciliation as a critical patient safety measure and key performance indicator (KPI). The medication reconciliation electronic form a computerized decision support tool was introduced to improve medication reconciliation compliance on transition of care at admission, transfer and discharge of patients both in the inpatient and outpatient settings. In order to improve medication reconciliation compliance a multidisciplinary task force team was formed and led this quality improvement project. The purpose of this publication is to indicate the quality improvement interventions implemented to enhance compliance with admission medication reconciliation and the outcomes of those interventions. We chose to conduct the pilot study in general medicine as it is the busiest department in the hospital, with an average of 390 patients admitted per month during the study period. The study period was from April 2014 till October 2015 and a total of 8576 patients were evaluated. The lessons learned were disseminated throughout the hospital. Our aim was to improve admission medication reconciliation compliance using the electronic form in order to ensure patient safety and reduce preventable harm in terms of medication errors. Admission medication reconciliation compliance improved in general medicine from 40% to above 85%, and this improvement was sustained for the last four months of the study period. PMID:27822371

  9. Optimizing urine drug testing for monitoring medication compliance in pain management.

    Science.gov (United States)

    Melanson, Stacy E F; Ptolemy, Adam S; Wasan, Ajay D

    2013-12-01

    It can be challenging to successfully monitor medication compliance in pain management. Clinicians and laboratorians need to collaborate to optimize patient care and maximize operational efficiency. The test menu, assay cutoffs, and testing algorithms utilized in the urine drug testing panels should be periodically reviewed and tailored to the patient population to effectively assess compliance and avoid unnecessary testing and cost to the patient. Pain management and pathology collaborated on an important quality improvement initiative to optimize urine drug testing for monitoring medication compliance in pain management. We retrospectively reviewed 18 months of data from our pain management center. We gathered data on test volumes, positivity rates, and the frequency of false positive results. We also reviewed the clinical utility of our testing algorithms, assay cutoffs, and adulterant panel. In addition, the cost of each component was calculated. The positivity rate for ethanol and 3,4-methylenedioxymethamphetamine were us to optimize our testing panel for monitoring medication compliance in pain management and reduce cost. Wiley Periodicals, Inc.

  10. A comparison of medication administration errors from original medication packaging and multi-compartment compliance aids in care homes: A prospective observational study.

    Science.gov (United States)

    Gilmartin-Thomas, Julia Fiona-Maree; Smith, Felicity; Wolfe, Rory; Jani, Yogini

    2017-07-01

    No published study has been specifically designed to compare medication administration errors between original medication packaging and multi-compartment compliance aids in care homes, using direct observation. Compare the effect of original medication packaging and multi-compartment compliance aids on medication administration accuracy. Prospective observational. Ten Greater London care homes. Nurses and carers administering medications. Between October 2014 and June 2015, a pharmacist researcher directly observed solid, orally administered medications in tablet or capsule form at ten purposively sampled care homes (five only used original medication packaging and five used both multi-compartment compliance aids and original medication packaging). The medication administration error rate was calculated as the number of observed doses administered (or omitted) in error according to medication administration records, compared to the opportunities for error (total number of observed doses plus omitted doses). Over 108.4h, 41 different staff (35 nurses, 6 carers) were observed to administer medications to 823 residents during 90 medication administration rounds. A total of 2452 medication doses were observed (1385 from original medication packaging, 1067 from multi-compartment compliance aids). One hundred and seventy eight medication administration errors were identified from 2493 opportunities for error (7.1% overall medication administration error rate). A greater medication administration error rate was seen for original medication packaging than multi-compartment compliance aids (9.3% and 3.1% respectively, risk ratio (RR)=3.9, 95% confidence interval (CI) 2.4 to 6.1, ppackaging (from original medication packaging-only care homes) and multi-compartment compliance aids (RR=2.3, 95%CI 1.1 to 4.9, p=0.03), and between original medication packaging and multi-compartment compliance aids within care homes that used a combination of both medication administration

  11. Personal and social factors regarding medical non-compliance in cardiac failure patients

    International Nuclear Information System (INIS)

    Mujtaba, S.F.; Masood, T.; Khalid, D.

    2011-01-01

    Objective: To determine the frequency and association of various personal and social factors with medical non-compliance in cardiac failure patients. Study Design: Cross-sectional, observational study. Place and Duration of Study: National Institute of Cardiovascular Diseases (NICVD), Karachi from January to August 2010. Methodology: Patients admitted in the medical wards of NICVD, who were being treated for cardiac failure, were included. Information regarding basic demographics, education level, self engagement in therapy and status of compliance was obtained by questionnaire. Statistical analysis was carried out by using Fisher's exact test and chi-square. Level of significance was < 0.05. Data was analyzed using SPSS V-15. Out of 267 patients, 73 (27.3%) were compliant while 194 (72.7%) were non-compliant. Educated, self caring patient, and those who knew names of their medications were more compliant than the rest. Conclusion: Medical non-compliance is very common in heart failure patients. Illiteracy and no self engagement in therapy are associated with non-compliance. (author)

  12. Medication apprehension and compliance among dialysis patients--a comprehensive guidance attitude.

    Science.gov (United States)

    Katzir, Ze'ev; Boaz, Mona; Backshi, Irena; Cernes, Relu; Barnea, Zvi; Biro, Alexander

    2010-01-01

    Compliance with treatment regimens is a continuing challenge for chronic dialysis patients and their medical caregivers. Poor patient adherence to prescribed medications can adversely affect treatment outcome. In this pre- versus post-intervention study, 89 chronic dialysis patients [75 hemodialysis (HD), 14 continuous ambulatory peritoneal dialysis (CAPD); mean age 62.7 +/- 12.39 years, 34 females] responded to a written questionnaire designed to assess knowledge about and compliance with 5 groups of prescribed medications: metabolic drugs, antihypertensives, cardiac-supporting agents, peptic disease therapy and hematological replacement therapy. Mode of intake, storage, means of supply and source of information for each class of drug were also assessed. Patients then received both oral and written instructions regarding their prescribed medications (intervention). This information was repeated 3 months later. Six months after the intervention, patients were re-administered the questionnaires. Response to the questionnaires and laboratory data were compared prior to and following the intervention. Overall, compliance with prescribed medications significantly improved following the intervention, from 89 to 95.7%, p = 0.0007. This relative improvement was greater in HD than CAPD patients (27 vs. 2%, p dialysis vintage. Compared to baseline values, post-intervention blood hemoglobin, hematocrit, mean corpuscular volume, ferritin and Ca levels were significantly improved. Dialysis patients appear to benefit from receiving comprehensive guidance about medications, in terms of compliance with medications and blood chemistry and hematology measures. (c) 2009 S. Karger AG, Basel.

  13. Compliance to medication among hypertensive patients in Murtala ...

    African Journals Online (AJOL)

    %). Patients ... A major factor accounting for inadequate ... counting the remaining pills or pill counting systems). ... Information obtained included socio- .... medication compliance on the control of hypertension. ... Archives of Internal Medicine.

  14. Compliance and Cognitive Function: A Methodological Approach to Measuring Unintentional Errors in Medication Compliance in the Elderly.

    Science.gov (United States)

    Isaac, Lisa M.; And Others

    1993-01-01

    Assessed multiple aspects of cognitive performance, medication planning ability, and medication compliance in 20 elderly outpatients. Findings suggest that aspects of attention/concentration, visual and verbal memory, and motor function which are untapped by simple mental status assessment are related to medication access, planning, and compliance…

  15. Medication compliance behavior in psychiatric out‑patients with ...

    African Journals Online (AJOL)

    2014-10-24

    Oct 24, 2014 ... No statistically significant relationship was found between substance use ... Access this article online ... Medication compliance in psychiatric patients in Nigeria. 372 ... had seen their physician until the sample size of 208 was.

  16. Direct medical costs and medication compliance among fibromyalgia patients: duloxetine initiators vs. pregabalin initiators.

    Science.gov (United States)

    Sun, Peter; Peng, Xiaomei; Sun, Steve; Novick, Diego; Faries, Douglas E; Andrews, Jeffrey S; Wohlreich, Madelaine M; Wu, Andrew

    2014-01-01

    To assess and compare direct medical costs and medication compliance between patients with fibromyalgia who initiated duloxetine and patients with fibromyalgia who initiated pregabalin in 2008. A retrospective cohort study design was used based on a large US national commercial claims database (2006 to 2009). Patients with fibromyalgia aged 18 to 64 who initiated duloxetine or pregabalin in 2008 and who had continuous health insurance 1 year preceding and 1 year following the initiation were selected into duloxetine cohort or pregabalin cohort based on their initiated agent. Medication compliance was measured by total supply days, medication possession ratio (MPR), and proportion of patients with MPR ≥ 0.8. Direct medical costs were measured by annual costs per patient and compared between the cohorts in the year following the initiation. Propensity score stratification and bootstrapping methods were used to adjust for distribution bias, as well as cross-cohort differences in demographic, clinical and economic characteristics, and medication history prior to the initiation. Both the duloxetine (n = 3,033) and pregabalin (n = 4,838) cohorts had a mean initiation age around 49 years, 89% were women. During the postindex year, compared to the pregabalin cohort, the duloxetine cohort had higher totally annual supply days (273.5 vs. 176.6, P costs ($2,994.9 vs. $4,949.6, P costs ($8,259.6 vs. $10,312.2, P costs ($5,214.6 vs. $5,290.8, P > 0.05), and lower total medical costs ($16,469.1 vs. $20,552.6, P compliance and consumed less inpatient, outpatient, and total medical costs than those who initiated pregabalin. © 2013 The Authors Pain Practice © 2013 World Institute of Pain.

  17. What role does measuring medication compliance play in evaluating the efficacy of naltrexone?

    Science.gov (United States)

    Baros, Alicia M; Latham, Patricia K; Moak, Darlene H; Voronin, Konstantin; Anton, Raymond F

    2007-04-01

    Compliance with medication in pharmacotherapy trials of alcoholism has been shown to be equal to, or more, important than in other areas of medicine. Research has suggested that naltrexone's effectiveness can be greatly influenced by the compliance of participants in clinical trials. Presently, we compare 2 compliance measurement methods [urine riboflavin and medication event monitoring system (MEMS)] used simultaneously to evaluate naltrexone's efficacy and the impact of compliance on the size of observable treatment effects. One hundred and thirty-seven of 160 randomized alcoholic patients completed 12-weeks (84 days) of naltrexone or placebo and cognitive behavioral therapy (CBT) or motivational enhancement therapy (MET). Urine riboflavin was determined during study weeks 2, 6, and 12. The MEMS provided a detailed computerized record of when a participant opened their medication bottle throughout the trial. Baseline predictors of MEMS (80% openings) and urine riboflavin (>or=1,500 ng/mL by fluorimetry) compliance were examined. The effects of the treatments in the compliant participants defined by one, the other, or both methods were compared and contrasted with a previously reported intent-to-treat analysis where compliance was not taken into account. Age was predictive of compliance. 105 participants were deemed compliant via urine riboflavin criteria, 87 via MEMS, and 77 when both criteria were met, with no significant differences between treatment groups. The most compliant participants showed a significant medication by therapy interaction. Those treated with naltrexone/CBT showed more abstinence days (pcompliance measurement methods. Compliance measurement does appear to influence the evaluation of the efficacy of naltrexone within the context of CBT. Treatment effect sizes approximately doubled in the most compliant individuals. Measuring compliance by either of 2 distinct methods provides approximately similar results. As compliance with naltrexone

  18. Compliance to topical anti-glaucoma medications among patients at a tertiary hospital in North India

    Directory of Open Access Journals (Sweden)

    Ketaki Rajurkar

    2018-06-01

    Full Text Available Purpose: The present study aims to estimate the prevalence of non-compliance and improper drop administration technique among glaucoma patients and describe common obstacles to medication compliance. Methods: A hospital-based cross-sectional study, using standardized questionnaire and direct observation by study personnel was conducted among glaucoma patients aged 18 years and above at a tertiary care charitable eye hospital in North India. 151 consecutive glaucoma patients on medical therapy following up at the glaucoma clinics for at least 6 months were recruited. Non-compliance was defined as missing at-least one drop of medication per week and (or the inability to accurately describe the medication regimen. Study personnel also assessed drop administration technique during application of eye drops by patients treating ophthalmologist-provided information, including measures of disease stability. Factors such as socioeconomic status, presence of caregiver, and number of medications with their effect on compliance were studied using chi-square statistics. Results: Among 151 patients interviewed, around 49% of patients reported problems in using glaucoma medications, with 16% of them reporting total non-compliance. 35% of patients demonstrated improper drop administration technique. Forgetfulness was cited as the main reason for being non-compliant and had a significant association with non-compliance (P = 0.00. Paying patients were more compliant as compared to subsidized patients (P = 0.05. Disease was more stable in compliant patients compared to non-compliant patients (P = 0.05. No other factor had significant association with compliance (P > 0.05. Conclusions: Over 50% of the patients surveyed were non-compliant, and 35% demonstrated improper administration technique. Glaucoma patients should be educated on the importance of compliance and aids that minimize forgetfulness, and delivery systems facilitating the delivery of

  19. Understanding how to maintain compliance in the current regulatory climate

    International Nuclear Information System (INIS)

    Bignell, D.T.; Burns, R.

    1995-01-01

    High level radioactive waste facilities must maintain compliance with all regulatory requirements, even those requirements that have been promulgated after the facility was placed into operation. Facilities must aggressively pursue compliance because environmental laws often impose strict liability for violations; therefore, an honest mistake is no defense. Radioactive waste management is constantly under the public microscope, particularly those facilities that handle high-level radioactive waste. The Savannah River Site has effectively met the challenges of regulatory compliance in its HLRW facilities and plans are being formulated to meet future regulatory requirements as well. Understanding, aggressively achieving, and clearly demonstrating compliance is essential for the continued operations of radioactive waste management facilities. This paper examines how HLRW facilities are impacted by regulatory requirements and how compliance in this difficult area is achieved and maintained

  20. Establishing Compliance with Liquid Medication Administration in a Child with Autism

    Science.gov (United States)

    Schiff, Averil; Tarbox, Jonathan; Lanagan, Taira; Farag, Peter

    2011-01-01

    Children with autism often display difficulty with swallowing pills and liquid medications. In the current study, stimulus fading and positive reinforcement established compliance with liquid medication administration in a young boy with autism. The boy's mother eventually administered liquid medication on her own. (Contains 1 figure.)

  1. A Study to Determine the Correlation between Continuity of Care and Patient Medication Compliance

    Science.gov (United States)

    1984-08-01

    U (III FILE ’Y TO DETERMINE THE CORRELATION BETWEEN CONTINUITY OF CARE AND PATIENT MEDICATION COMPLIANCE IA Graduate Research Project Submitted to...43 APPENDIX A. PATIENT MEDICATION COMPLIANCE QUESTIONNAIRE . . . . . 45 B. COMPUTER CODED INPUT FORMAT . . . . . . . ...... 48 C. RESEARCH DATA...and that adhered to by the patient . This failure to comply with medical recommendations results in a waste of health resources, frustration to the

  2. Compliance with hygiene procedures among medical faculty students

    Directory of Open Access Journals (Sweden)

    Anna Kawalec

    2014-10-01

    Full Text Available Background: Many of the healthcare-associated infections (HCAIs are transmitted by healthcare workers’ hands, which actively contributes to transferring pathogens from patient to patient and within the healthcare environment. Hand hygiene is the easiest and cheapest method for preventing HCAIs. The article presents the compliance with hygiene procedures in a group of medical students of the Wroclaw Medical University. Material and Methods: The anonymous survey was conducted among 112 students. The survey included questions about the frequency of disinfection of hands and stethoscopes, changing clothes into clean ones, compliance with recommendations for healthcare workers, as well as subjective assessment of the availability of disinfectants in the hospital. Results: The results of the survey revealed that 35.7% of students did not disinfect their hands before each patient’s examination, 90% of them indicated limited access to disinfectants as the most important reason. The majority (93.8% of respondents were trained in hand hygiene. In 34.82% the availability of disinfectants in hospitals was assesed as good, 62.5% of respondents drew attention to the fact that the dispensers were often empty. Compliance with recommendations for healthcare workers: 66.9% posessed white coat with short sleeves, 52.68% wore wristwatch or jewelery on their hands, 50% of students laundered white coat less frequently than once a week, 9.82% did not disinfect their stethoscope at all, 15.18% did that before each patient’s examination. Conclusions: Students compliance with hand hygiene now and in their future work as doctors is the easiest method for preventing HCAIs. Providing easy access to disinfectants in the hospital environment and shaping hygiene habits during clinical activities play an essential role. Med Pr 2014;65(5:593–599

  3. PCI compliance understand and implement effective PCI data security standard compliance

    CERN Document Server

    Williams, Branden R

    2012-01-01

    The credit card industry established the PCI Data Security Standards to provide a minimum standard for how vendors should protect data to ensure it is not stolen by fraudsters. PCI Compliance, 3e, provides the information readers need to understand the current PCI Data Security standards, which have recently been updated to version 2.0, and how to effectively implement security within your company to be compliant with the credit card industry guidelines and protect sensitive and personally identifiable information. Security breaches continue to occur on a regular basis, affecting millions of

  4. Compliance with referrals to medical specialist care: patient and general practice determinants: a cross-sectional study.

    Science.gov (United States)

    van Dijk, Christel E; de Jong, Judith D; Verheij, Robert A; Jansen, Tessa; Korevaar, Joke C; de Bakker, Dinny H

    2016-02-01

    In a gatekeeper system, primary care physicians and patients jointly decide whether or not medical specialist care is needed. However, it is the patient who decides to actually use the referral. Referral non-compliance could delay diagnosis and treatment. The objective of this study was to assess patient compliance with a referral to medical specialist care and identify patient and practice characteristics that are associated with it. Observational study using data on 48,784 referrals to medical specialist care derived from electronic medical records of 58 general practices for the period 2008-2010. Referral compliance was based on claims data of medical specialist care. Logistic multilevel regression analyses were conducted to determine associations between patient and general practice characteristics and referral compliance. In 86.6% of the referrals, patients complied. Patient and not practice characteristics were significantly associated with compliance. Patients from deprived urban areas and patients aged 18-44 years were less likely to comply, whereas patients aged 65 years and older were more likely to comply. About 1 in 8 patients do not use their referral. These patients may not receive adequate care. Demographic and socio-economic factors appear to affect compliance. The results of this study may be used to make general practitioners more aware that some patients are more likely to be noncompliant with referrals.

  5. Non-compliance to anti-hypertensive medication and its associated factors among hypertensives

    International Nuclear Information System (INIS)

    Bilal, A.; Riaz, M.; Shafiq, N.U.; Ahmed, M.; Sheikh, S.; Rasheed, S.

    2015-01-01

    Non-compliance to anti-hypertensive drugs can have negative impact on cardiovascular outcome. Various studies have been conducted on the issue but the factors are not yet explored properly, particularly in Pakistan. This study was conducted to determine the frequency and factors associated with non-compliance to anti-hypertensive medications in Karachi. Methods: This descriptive cross sectional study was conducted on 113 indoor hypertensive patients included by purposive sampling, aged 30 years and above diagnosed at least 6 months back in public sector tertiary care institutes of Karachi from March to October 2011. Data was collected through a questionnaire in Urdu. Demographic data, hypertension diagnosis, medical co-morbidity, current number of anti-hypertensive medicines, frequency of missing prescribed antihypertensive therapy and other factors affecting compliance pertaining to medicines, patient, physician and health care centre were included in the questionnaire. Results: This study revealed that 68.14% patients were non-compliant. Non-compliance was found to be associated with gender and socioeconomic status. Duration of hypertension, duration between follow up visits to physician, number of drugs, careless attitude, role of physician and limiting access to health care center are found to be important factors in non-compliance. Conclusions: Multiple factors including patients, medicine and health care system related, which can be prevented with simple measures, were found responsible for higher prevalence of non-compliance against anti-hypertensive medicines. (author)

  6. PCI Compliance Understand and Implement Effective PCI Data Security Standard Compliance

    CERN Document Server

    Chuvakin, Anton

    2010-01-01

    Identity theft and other confidential information theft have now topped the charts as the #1 cybercrime. In particular, credit card data is preferred by cybercriminals. Is your payment processing secure and compliant?. Now in its second edition, PCI Compliance has been revised to follow the new PCI DSS standard 1.2.1. Also new to this edition: Each chapter has how-to guidance to walk you through implementing concepts, and real-world scenarios to help you relate to the information and better grasp how it impacts your data. This book provides the information that you need to understand the curre

  7. Improved Hand Hygiene Compliance is Associated with the Change of Perception toward Hand Hygiene among Medical Personnel

    Science.gov (United States)

    Park, Se Jeong; Chung, Moon Joo; Lee, Ju Hee; Kang, Hyun Joo; Lee, Jeong-a; Kim, Yong Kyun

    2014-01-01

    Background Hand hygiene compliance has improved significantly through hand hygiene promotion programs that have included poster campaign, monitoring and performance feedback, and education with special attentions to perceived subjective norms. We investigated factors associated with improved hand hygiene compliance, focusing on whether the improvement of hand hygiene compliance is associated with changed perception toward hand hygiene among medical personnel. Materials and Methods Hand hygiene compliance and perceptions toward hand hygiene among medical personnel were compared between the second quarter of 2009 (before the start of a hand hygiene promotion program) and the second quarter of 2012. We assessed adherence to hand hygiene among medical personnel quarterly according to the WHO recommended method for direct observation. Also, we used a modified self-report questionnaire to collect perception data. Results Hand hygiene compliance among physicians and nurses improved significantly from 19.0% in 2009 to 74.5% in 2012 (P Hand hygiene compliance among the medical personnel continued to improve, with a slight decline in 2013. Perceptions toward hand hygiene improved significantly between 2009 and 2012. Specifically, improvements were evident in intention to adhere to hand hygiene, knowledge about hand hygiene methods, knowledge about hand hygiene indications including care of a dirty and a clean body site on the same patient, perceived behavioral and subjective norms, positive attitude toward hand hygiene promotion campaign, perception of difficulty in adhering to hand hygiene, and motivation to improve adherence to hand hygiene. Conclusions The examined hand hygiene promotion program resulted in improved hand hygiene compliance and perception toward hand hygiene among medical personnel. The improved perception increased hand hygiene compliance. Especially, the perception of being a role model for other colleagues is very important to improve hand hygiene

  8. Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation.

    Science.gov (United States)

    Noordraven, Ernst L; Wierdsma, André I; Blanken, Peter; Bloemendaal, Anthony Ft; Mulder, Cornelis L

    2016-01-01

    Noncompliance is a major problem for patients with a psychotic disorder. Two important risk factors for noncompliance that have a severe negative impact on treatment outcomes are impaired illness insight and lack of motivation. Our cross-sectional study explored how they are related to each other and their compliance with depot medication. Interviews were conducted in 169 outpatients with a psychotic disorder taking depot medication. Four patient groups were defined based on low or high illness insight and on low or high motivation. The associations between depot-medication compliance, motivation, and insight were illustrated using generalized linear models. Generalized linear model showed a significant interaction effect between motivation and insight. Patients with poor insight and high motivation for treatment were more compliant (94%) (95% confidence interval [CI]: 1.821, 3.489) with their depot medication than patients with poor insight and low motivation (61%) (95% CI: 0.288, 0.615). Patients with both insight and high motivation for treatment were less compliant (73%) (95% CI: 0.719, 1.315) than those with poor insight and high motivation. Motivation for treatment was more strongly associated with depot-medication compliance than with illness insight. Being motivated to take medication, whether to get better or for other reasons, may be a more important factor than having illness insight in terms of improving depot-medication compliance. Possible implications for clinical practice are discussed.

  9. The impact of cognitive insight, self-stigma, and medication compliance on the quality of life in patients with schizophrenia.

    Science.gov (United States)

    Lien, Yin-Ju; Chang, Hsin-An; Kao, Yu-Chen; Tzeng, Nian-Sheng; Lu, Chien-Wen; Loh, Ching-Hui

    2018-02-01

    Impaired quality of life (QoL) is a common and clinically relevant feature of schizophrenia. In the present study, we attempted to formulate a model of QoL in the chronic stage of schizophrenia by including key variables-namely cognitive insight, self-stigma, insight into treatment, and medication compliance-that were proposed as its significant predictors in previous studies. We employed structural equation modeling (SEM) to simultaneously test the associations between these variables. A total of 170 community-dwelling patients with schizophrenia participated in this study. Cognitive insight, self-stigma, insight into treatment, medication compliance, and QoL were assessed through self-reporting. Symptoms were rated by interviewers. The influences of cognitive insight, stigma, insight into treatment, and medication compliance on QoL were supported using SEM. Our findings indicated that cognitive insight had a significant, positive, and direct effect on both self-stigma and insight into treatment; in contrast, it had a negative and direct effect on medication compliance. Notably, no evidence indicated a direct effect of cognitive insight on QoL. Thus, individuals with high cognitive insight reported low QoL because of stigma, low medication compliance, and their increased insight into treatment. In contrast, cognitive insight might indirectly ameliorate QoL mediated by the effect of insight into treatment on medication compliance. The findings provide additional support of the links between cognitive and clinical insight, self-stigma, medication compliance, and QoL in those with schizophrenia and suggest the need for screening and intervention services appropriate for this high-risk population.

  10. Emergency Telemedicine: Achieving and Maintaining Compliance with the Emergency Medical Treatment and Labor Act.

    Science.gov (United States)

    Rockwell, Kimberly Lovett; Gilroy, Alexis

    2018-03-12

    Telemedicine is a growing and important platform for medical delivery in the emergency department. Emergency telemedicine outlays often confront and conflict with important federal healthcare regulations. Because of this, academic medical centers, critical access hospitals, and other providers interested in implementing emergency telemedicine have often delayed or forgone such services due to reasonable fears of falling out of compliance with regulatory restrictions imposed by the Emergency Medical Treatment and Labor Act ("EMTALA"). This article offers insights into methods for implementing emergency telemedicine services while maintaining EMTALA compliance. Critical analysis of EMTALA and its attendant regulations. The primary means of ensuring EMTALA compliance while implementing emergency telemedicine programs include incorporating critical clinical details into the services contracts and implementing robust written policies that anticipate division of labor issues, the need for backup coverage, triaging, patient transfer protocols, and credentialing issues. With adequate up-front due diligence and meaningful contracting, hospitals and telemedicine providers can avoid common EMTALA liability pitfalls.

  11. Economic impact of compliance to treatment with antidiabetes medication in type 2 diabetes mellitus: a review paper.

    Science.gov (United States)

    Breitscheidel, L; Stamenitis, S; Dippel, F-W; Schöffski, O

    2010-03-01

    Suboptimal compliance and failure to persist with antidiabetes therapies are of potential economic significance. The present research aims to describe the impact of poor compliance and persistence with antidiabetes medications on the cost of healthcare or its components for patients with type 2 diabetes mellitus (T2DM). Literature search was conducted in PubMed for relevant articles published in the period between 1 January 2000 and 30 April 2009. Thus, it is possible that relevant articles not listed in PubMed, but available in other databases are not included in the current review. Studies describing economic consequence of compliance and/or persistence with pharmaceutical antidiabetes treatment were identified. The variability in the studies reviewed was high, making it extremely difficult to make a comparison between them. Of 449 articles corresponding to the primary search algorithm, 12 studies (all conducted in USA) fulfilled the inclusion criteria regarding the economic impact of compliance and/or persistence with treatment on the overall cost of T2DM care or its components. Compliance was assessed via medication possession ratio (MPR) in ten studies, where it ranged from 0.52 to 0.93 depending on regimen. Persistence was assessed in one study. Mean total annual costs per T2DM patient varied between the studies, ranging from $4570 to $17338. In seven studies, medication compliance was inversely associated with total healthcare costs, while in four other studies inverse associations between medication compliance and hospitalisation costs were reported. In one study increased adherence did not change overall healthcare costs. Improved compliance may lead to reductions of the total healthcare costs in T2DM, Further research is needed in countries other than the US to assess impact of compliance and persistence to pharmacotherapy on T2DM costs in country-specific settings.

  12. Limited Awareness of the Essences of Certification or Compliance Markings on Medical Devices.

    Science.gov (United States)

    Foo, Jong Yong Abdiel; Tan, Xin Ji Alan

    2017-06-01

    Medical devices have been long used for odiagnostic, therapeutic or rehabilitation purposes. Currently, they can range from a low-cost portable device that is often used for personal health monitoring to high-end sophisticated equipment that can only be operated by trained professionals. Depending on the functional purposes, there are different certification or compliance markings on the device when it is sold. One common certification marking is the Conformité Européenne affixation but this has a range of certification mark numbering for a variety of functional purposes. While the regulators and medical device manufacturers understand the associated significance and clinical implications, these may not be apparent to the professionals (using or maintaining the device) and the general public. With portable healthcare devices and mobile applications gaining popularity, better awareness of certification marking will be needed. Particularly, there are differences in the allowed functional purposes and the associated cost derivations of devices with a seemingly similar nature. A preferred approach such as an easy-to-understand notation next to any certification marking on a device can aid in differentiation without the need to digest mountainous regulatory details.

  13. Understand Your Medication

    Science.gov (United States)

    ... Disease Lookup > Asthma > Living with Asthma > Managing Asthma Understand Your Asthma Medication There are a variety of ... healthcare team. They can help make sure you understand the correct way to take the medicines, or ...

  14. Compliance pluralisme and processes : Understanding compliance behavior in restaurants in China

    NARCIS (Netherlands)

    Wu, Y.

    2017-01-01

    This research aimed to offer a case study of dynamic compliance processes in selected Chinese restaurants with the main methods of participant observation and in-depth interviews. It applied an integrated and dynamic research approach, called descriptive analysis of compliance behavior, which

  15. FDA (Food and Drug Administration) Compliance Program Guidance Manual (FY 88). Section 4. Medical and radiological devices

    International Nuclear Information System (INIS)

    1988-01-01

    The FDA Compliance Program Guidance Manual provides a system for issuing and filing program plans and instructions directed to Food and Drug Administration Field operations for project implementation. Section IV provides those chapters of the Compliance Program Guidance Manual which pertain to the areas of medical and radiological devices. Some of the areas of coverage include laser and sunlamp standards inspections, compliance testing of various radiation-emitting products such as television receivers and microwave ovens, emergency response planning and policy, premarket approval and device manufacturers inspections, device problem reporting, sterilization of devices, and consumer education programs on medical and radiological devices

  16. The introduction of compulsory compliance testing of medical diagnostic x-ray equipment in Western Australia

    International Nuclear Information System (INIS)

    Rafferty, M. W.; Jacob, C. S.

    1995-01-01

    Performance testing of medical diagnostic X-ray equipment can reveal equipment faults which, while not always clinically detectable, may contribute to reduced image quality and unnecessary radiation exposure of both patients and staff. Routine testing of such equipment is highly desirable to identify such faults and allows them to be rectified. The Radiological council of Western Australia is moving towards requiring compulsory compliance testing of all (new and existing) medical diagnostic X-ray equipment that all new mobile radiographic and new mammographic X-ray equipment be issued with a compliance test certificate as a prerequisite for registration. Workbooks which provide details of the tests required and recommended test methods have been prepared for medical radiographic (mobile and fixed), fluoroscopic and mammographic X-ray equipment. It is intended that future workbooks include details of the tests and methods for dental and computed tomography X-ray units. The workbooks are not limited to the compliance testing of items as specified in the Regulations, but include tests for other items such as film processing, darkrooms and image quality (for fluoroscopic equipment). Many of the workbook tests could be used within a regular quality assurance program for diagnostic X-ray equipment. Persons who conduct such compliance tests will need to be licensed and have all test certificates endorsed by a qualified expert. Suitable training and assessment of compliance testers will be required. Notification of such tests (including non-compliant items and corrective actions taken) will be required by the Radiological Council as a condition of equipment registration. 9 refs

  17. Interventions for enhancing medication compliance/adherence with benefits in treatment outcomes

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2007-01-01

    Full Text Available Scientific background: Poor compliance or adherence in drug therapy can cause increased morbidity, mortality and enormous costs in the healthcare system (in Germany annually approximately 10 billion euros. Different methods are used for enhancing the compliance or adherence. Research questions: The evaluation addresses the questions about existence, efficacy, cost-benefit relation as well as ethical-social and juridical implications of strategies for enhancing compliance or adherence in drug therapy with concomitant improvements in treatment outcomes. Methods: A systematic literature search was conducted in the medical, also health economic relevant, literature databases in January 2007, beginning from 2002. Systematic reviews on the basis of (randomised controlled trials (RCT concerning interventions to enhance compliance or adherence with regard to treatment outcomes as well as systematic reviews of health economic analyses were included in the evaluation. Additionally, it was also searched for publications which primarily considered ethical-social and juridical aspects of these interventions for the German context. Results: One systematic review with data for 57 RCT was included in the medical evaluation and one systematic review with data for six studies into the health economic evaluation. No publication primary concerning ethical-social or juridical implications could be identified. A significant positive effect on the treatment outcome was reported for 22 evaluated interventions. For many interventions the results can be classified as reliable: counseling with providing an information leaflet and compliance diary chart followed by phone consultation for helicobacter pylori positive patients, repeated counseling for patients with acute asthma symptoms, telephone calls to establish the level of compliance and to make recommendations based on that for the therapy of cardiovascular diseases, calls of an automated telephone system with phone

  18. Improved Hand Hygiene Compliance is Associated with the Change of Perception toward Hand Hygiene among Medical Personnel

    OpenAIRE

    Lee, Seung Soon; Park, Se Jeong; Chung, Moon Joo; Lee, Ju Hee; Kang, Hyun Joo; Lee, Jeong-a; Kim, Yong Kyun

    2014-01-01

    Background Hand hygiene compliance has improved significantly through hand hygiene promotion programs that have included poster campaign, monitoring and performance feedback, and education with special attentions to perceived subjective norms. We investigated factors associated with improved hand hygiene compliance, focusing on whether the improvement of hand hygiene compliance is associated with changed perception toward hand hygiene among medical personnel. Materials and Methods Hand hygien...

  19. Social, Economic, and Medical Factors Associated With Solifenacin Therapy Compliance Among Workers Who Suffer From Lower Urinary Tract Symptoms.

    Science.gov (United States)

    Kosilov, Kirill Vladimirovich; Alexandrovich, Loparev Sergay; Gennadyevna, Kuzina Irina; Viktorovna, Shakirova Olga; Sergeevna, Zhuravskaya Natalia; Ivanovich, Ankudinov Ivan

    2016-09-01

    The prevalence of hyperactive-type lower urinary tract symptoms is 45.2%, with shares of overactive bladder (OAB) and urge incontinence (UI) symptoms of 10.7% and 8.2%, respectively. We investigated the possible impact of a wide range of social, economic, and medical factors on compliance with solifenacin treatment in the working population. Social, economic, and medical factors as well as the Overactive Bladder questionnaire - the OAB-q Short Form (OAB-q SF), bladder diaries, and uroflowmetry of 1,038 people who were administered solifenacin for a year were gathered from employer documentation. Among the subjects, 32% maintained their compliance with solifenacin treatment throughout the year. Only 65% of the patients had compliance exceeding 80%, and 17% of patients had compliance of ≥50%, yet less than 80% were still taking solifenacin 12 months after the beginning of this experiment. Working people whose compliance level was, at least, 80% had reliably higher (P≤0.01) average age, annual salary, and treatment efficacy, and a greater treatment satisfaction level, as well as a lack of satisfaction with other antimuscarinic treatments and higher rate of urge UI diagnosis. The same cohort also featured a lower level (P≤0.01) of caffeine abuse and lower share of salary spent purchasing solifenacin. This study has shown that compliance with solifenacin treatment is associated with a number of significant medical, social, and economic factors. The medical factors included the type of urination disorder, severity of incontinence symptoms, presence of side effects, treatment efficacy and patients' satisfaction with it, and experience using other antimuscarinic treatments. Among the social and economic factors, those with the strongest correlation to compliance were patient age, employment in medicine and education, annual income level, percentage of solifenacin purchase expenditures, and caffeine abuse. Factors with a weaker, but still significant, association were

  20. Understanding Recreational Fishers' Compliance with No-take Zones in the Great Barrier Reef Marine Park

    Directory of Open Access Journals (Sweden)

    Adrian Arias

    2013-12-01

    Full Text Available Understanding fishers' compliance is essential for the successful management of marine protected areas. We used the random response technique (RRT to assess recreational fishers' compliance with no-take zones in the Great Barrier Reef Marine Park (GBRMP. The RRT allowed the asking of a sensitive question, i.e., "Did you, knowingly, fish within in a Green Zone during the last 12 months?" while protecting respondents' confidentiality. Application of the RRT through a survey of recreational fishers indicated that the majority of recreational fishers, 90%, comply with no-take zones. Likewise, most fishers, 92%, reported not personally knowing anyone who had intentionally fished in a no-take zone, indicating that fishers' perceive high levels of compliance among their peers. Fishers were motivated to comply with no-take zones primarily by their beliefs about penalties for noncompliance, followed by beliefs about the fishery benefits of no-take zones. Results suggest that compliance-related communication efforts by the managing authority have partially succeeded in maintaining appropriate compliance levels and that future efforts should accentuate normative compliance drivers that will encourage voluntary compliance. We conclude that compliance monitoring should be integrated into the adaptive management of the GBRMP and other protected areas; in this case social surveys using the RRT are effective tools.

  1. Analysis of Factors Affecting Patients’ Compliance to Topical Antiglaucoma Medications in Egypt as a Developing Country Model

    Directory of Open Access Journals (Sweden)

    Nahla B. Abu Hussein

    2015-01-01

    Full Text Available Purpose. To study factors affecting patients’ compliance to antiglaucoma medications in Egypt where there are unique factors as a developing country. Patients and Methods. A cross-sectional descriptive study on 440 Egyptian patients with open angle glaucoma (OAG recruited for over two years. The patients were thoroughly interviewed about their age, education level, duration of glaucoma, difficulty in instilling the drops, medication regimens, a family history of glaucoma, knowledge of the disease, and the presence of medical insurance. Results. 236 (53.6% were noncompliant compared to 204 (46.4% who were compliant. Females had a tendency for higher compliance (p=0.061. Patient age above 50 years and low level of education and negative family history of glaucoma were factors significantly associated with poor compliance (p<0.0001. Polytherapy and lack of medical insurance could be contributing factors. Conclusion. Egyptian patients have a high rate of noncompliance compared to the average in literature. Great effort is needed in educating patients about the importance of medications and the risk and the prognosis of this disease. Economic factors must also be taken into consideration in developing countries with large number of poor patients. We recommend simplifying drug regimens, incorporating electronic dose monitors, and creating reminders for follow-up visits of glaucoma patients.

  2. Understanding Medical Words

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Understanding Medical Words Past Issues / Summer 2009 Table of Contents For ... Medicine that teaches you about many of the words related to your health care Do you have ...

  3. Perceived treatment effectiveness, medication compliance, and complementary and alternative medicine use among veterans with bipolar disorder.

    Science.gov (United States)

    Jarman, Christopher N; Perron, Brian E; Kilbourne, Amy M; Teh, Carrie Farmer

    2010-03-01

    Recent research shows a high rate of complementary and alternative medicine (CAM) use among persons with mental disorders, although correlates and patterns of CAM use are relatively unknown. This study tested whether CAM use is associated with perceived effectiveness of conventional treatment (i.e., psychotropic medication and psychotherapy) and medication compliance among persons with bipolar disorder. Patients with bipolar disorder (n = 435) were included as part of a naturalistic cohort study. Measures of CAM utilization, medication compliance, and perceptions of the effectiveness of psychotropic medications and psychotherapy were based on previously established questionnaires. Associations were tested using bivariate and multivariate analyses. Bivariate analyses showed that patients who did not perceive psychotherapy as effective at improving social, family, or job functioning reported greater CAM use. However, medication compliance was not significantly associated with use of CAM. Patients who used oral (e.g., herbal therapies) or cognitive (e.g., meditation) CAM were more likely to report that their medications were not effective at relieving manic or depressive symptoms. Users of cognitive CAM were more likely to report that their medications did not help with social, job, or family functioning, and that they did not prevent recurrences of manic or depressive episodes. None of the bivariate associations remained significant in multivariate analyses. Prior research has suggested that persons who are dissatisfied with treatment for medical conditions are more likely to use CAM therapies. However, the results of this study do not show CAM therapies to be associated with perceived effectiveness of treatments for mental health problems among this sample of persons with serious mental illnesses. This suggests that motivations for CAM use may vary by population and condition. Because few correlates of CAM use among persons with serious mental illnesses are known

  4. Compliance with RSV prophylaxis: Global physicians’ perspectives

    Directory of Open Access Journals (Sweden)

    Kari S Anderson

    2009-07-01

    Full Text Available Kari S Anderson, Victoria M Mullally, Linda M Fredrick, Andrew L CampbellAbbott Laboratories, Abbott Park, IL, USAAbstract: Respiratory syncytial virus (RSV is a significant cause of morbidity in high-risk infants. Palivizumab is proven to prevent serious RSV disease, but compliance with prophylaxis (monthly doses during the RSV season is essential to ensure protection. We invited 453 pediatricians to participate in a survey to identify their perspectives of barriers to compliance and interventions to improve compliance with palivizumab prophylaxis schedules. One hundred physicians from five continents completed the survey, identifying caregiver inconvenience, distance to clinic, cost of prophylaxis, and lack of understanding of the severity of RSV as the most common reasons for noncompliance. They recommended provision of educational materials about RSV, reminders from hospital or clinic, and administration of prophylaxis at home to increase compliance. Globally, physicians recognize several obstacles to prophylaxis compliance. This survey suggests that focused proactive interventions such as empowering caregivers with educational materials and reducing caregiver inconvenience may be instrumental to increase compliance.Keywords: medication adherence, respiratory syncytial virus infections, infant, premature, immunization, passive

  5. Learning from “Shadow Security”: Why understanding non-compliance provides the basis for effective security

    OpenAIRE

    Kirlappos, I.; Parkin, S.; Sasse, M. A.

    2014-01-01

    Over the past decade, security researchers and practitioners have tried to understand why employees do not comply with organizational security policies and mechanisms. Past re-search has treated compliance as a binary decision: people comply, or they do not. From our analysis of 118 in-depth interviews with individuals (employees in a large multinational organization) about security non-compliance, a 3rd response emerges: shadow security. This describes the instances where security-conscious ...

  6. ‘And you’ll suddenly realise ‘I’ve not washed my hands’: medical students’, junior doctors’ and medical educators’ narratives of hygiene behaviours

    Science.gov (United States)

    Cresswell, Penelope

    2018-01-01

    Objective Compliance to hygiene behaviours has long been recognised as important in the prevention and control of healthcare associated infections, but medical doctors still display some of the lowest rates of compliance of all healthcare workers. We aim to understand compliance to hygiene behaviours by analysing medical students’, junior doctors’ and medical educators’ narratives of these behaviours to identify their respective attitudes and beliefs around compliance and how these are learnt during training. Such an understanding can inform future interventions to improve compliance targeted to areas of greatest need. Design A qualitative study, using narrative interviews (nine focus groups and one individual interview). Data were analysed thematically using inductive framework analysis. Setting Teaching hospitals in the UK. Participants Convenience sample of 25 participants: third-year medical students in their first clinical year (n=13), junior doctors (n=6) and medical educators (n=6). Results We identified four main themes: (1) knowledge, (2) constraints, (3) role models/culture and (4) hygiene as an added extra. Knowledge varied across participant groups and appeared to influence behaviours; medical students relied on what they have been told by seniors, while medical educators relied on their own knowledge and experience. There was a strong belief that evidence for the effectiveness of good hygiene behaviours is lacking. Furthermore, medical educators’ behaviour appears to strongly influence others. Finally, hygiene was predominately viewed as an added extra rather than an integral part of the process. Conclusions Awareness of the evidence around good hygiene needs to be improved at all levels. Medical students and junior doctors should be encouraged to consider why they are asked to perform certain hygiene behaviours in order to improve ownership of those behaviours. Medical educators need to recognise their responsibilities as role models for their

  7. Social, Economic, and Medical Factors Associated With Solifenacin Therapy Compliance Among Workers Who Suffer From Lower Urinary Tract Symptoms

    Directory of Open Access Journals (Sweden)

    Kirill Vladimirovich Kosilov

    2016-09-01

    Full Text Available Purpose The prevalence of hyperactive-type lower urinary tract symptoms is 45.2%, with shares of overactive bladder (OAB and urge incontinence (UI symptoms of 10.7% and 8.2%, respectively. We investigated the possible impact of a wide range of social, economic, and medical factors on compliance with solifenacin treatment in the working population. Methods Social, economic, and medical factors as well as the Overactive Bladder questionnaire – the OAB-q Short Form (OAB-q SF, bladder diaries, and uroflowmetry of 1,038 people who were administered solifenacin for a year were gathered from employer documentation. Results Among the subjects, 32% maintained their compliance with solifenacin treatment throughout the year. Only 65% of the patients had compliance exceeding 80%, and 17% of patients had compliance of ≥50%, yet less than 80% were still taking solifenacin 12 months after the beginning of this experiment. Working people whose compliance level was, at least, 80% had reliably higher (P≤0.01 average age, annual salary, and treatment efficacy, and a greater treatment satisfaction level, as well as a lack of satisfaction with other antimuscarinic treatments and higher rate of urge UI diagnosis. The same cohort also featured a lower level (P≤0.01 of caffeine abuse and lower share of salary spent purchasing solifenacin. Conclusions This study has shown that compliance with solifenacin treatment is associated with a number of significant medical, social, and economic factors. The medical factors included the type of urination disorder, severity of incontinence symptoms, presence of side effects, treatment efficacy and patients’ satisfaction with it, and experience using other antimuscarinic treatments. Among the social and economic factors, those with the strongest correlation to compliance were patient age, employment in medicine and education, annual income level, percentage of solifenacin purchase expenditures, and caffeine abuse. Factors

  8. Symptom experience associated with immunosuppressive drugs after liver transplantation in adults : possible relationship with medication non-compliance?

    NARCIS (Netherlands)

    Drent, Gerda; Moons, P.; De Geest, S.; Kleibeuker, J. H.; Haagsma, E. B.

    2008-01-01

    Symptom experience (occurrence and perceived distress) associated with side effects of immunosuppressive medications in organ transplant patients may well be associated with poorer quality of life and medication non-compliance. The aims of this study were: first, to assess symptom experience in

  9. The everyday elasticity of compliance in a symptomless disease

    DEFF Research Database (Denmark)

    Felde, Lina Hoel

    2011-01-01

    Medically, compliance refers to the extent to which a patient's response to medical advice coincides with doctors' orders. Rather than this absolute standard, this article treats compliance as an institutionally available discourse continually figured in practice. The aim of this article is to de......Medically, compliance refers to the extent to which a patient's response to medical advice coincides with doctors' orders. Rather than this absolute standard, this article treats compliance as an institutionally available discourse continually figured in practice. The aim of this article...... give-and-take. This elasticity of compliance reveals a reflexive critique of medical compliance as a moral standard and leads us to discuss how people are adequately compliant in everyday moral contexts....

  10. FDA (Food and Drug Administration) compliance program guidance manual and updates (FY 86). Section 4. Medical and radiological devices. Irregular report

    International Nuclear Information System (INIS)

    1986-01-01

    The FDA Compliance Program Guidance Manual provides a system for issuing and filing program plans and instructions directed to Food and Drug Administration Field operations for project implementation. Section IV provides those chapters of the Compliance Program Guidance Manual which pertain to the areas of medical and radiological devices. Some of the areas of coverage include laser and sunlamp standards inspections, compliance testing of various radiation-emitting products such as television receivers and microwave ovens, emergency response planning and policy, premarket approval and device manufacturers inspections, device problem reporting, sterilization of devices, and consumer education programs on medical and radiological devices

  11. 'And you'll suddenly realise 'I've not washed my hands': medical students', junior doctors' and medical educators' narratives of hygiene behaviours.

    Science.gov (United States)

    Cresswell, Penelope; Monrouxe, Lynn V

    2018-03-22

    Compliance to hygiene behaviours has long been recognised as important in the prevention and control of healthcare associated infections, but medical doctors still display some of the lowest rates of compliance of all healthcare workers. We aim to understand compliance to hygiene behaviours by analysing medical students', junior doctors' and medical educators' narratives of these behaviours to identify their respective attitudes and beliefs around compliance and how these are learnt during training. Such an understanding can inform future interventions to improve compliance targeted to areas of greatest need. A qualitative study, using narrative interviews (nine focus groups and one individual interview). Data were analysed thematically using inductive framework analysis. Teaching hospitals in the UK. Convenience sample of 25 participants: third-year medical students in their first clinical year (n=13), junior doctors (n=6) and medical educators (n=6). We identified four main themes: (1) knowledge, (2) constraints, (3) role models/culture and (4) hygiene as an added extra. Knowledge varied across participant groups and appeared to influence behaviours; medical students relied on what they have been told by seniors, while medical educators relied on their own knowledge and experience. There was a strong belief that evidence for the effectiveness of good hygiene behaviours is lacking. Furthermore, medical educators' behaviour appears to strongly influence others. Finally, hygiene was predominately viewed as an added extra rather than an integral part of the process. Awareness of the evidence around good hygiene needs to be improved at all levels. Medical students and junior doctors should be encouraged to consider why they are asked to perform certain hygiene behaviours in order to improve ownership of those behaviours. Medical educators need to recognise their responsibilities as role models for their junior counterparts, thereby understanding their role in

  12. [A role of motivation for treatment in the structure of compliance in psychopharmacologically treated patients].

    Science.gov (United States)

    Sorokin, M Yu; Lutova, N B; Wied, V D

    2016-01-01

    To reveal an impact of specific motivation structures on the compliance in psychiatric inpatients. The Treatment Motivation Questionnaire and the Medication Compliance Scale have been administered to 104 patients, including 67 patients with schizophrenia and schizophrenia-spectrum disorders, 15 with affective disorders, 13 with personality and neurotic disorders and 9 with organic disorders, of the department of integrative pharmaco- and psychotherapy. A motivational mechanism based on the subjective suffering from disease plays a key role in the formation of overall score of compliance. Amotivation syndrome has a negative impact on the compliance. "Passive agreement" attitude to treatment corresponds to a deficiency in both patient and physician compliance subsystems along with a reduction in insight and cognitive functions in the patient's subsystem. Extreme external motivation for treatment correlates with insufficiently constructive support on the part of significant others in patient's environment subsystem resulting in the delay of internal motivation development. Extremely low scores based on understanding of disease character leads to the deficiency of medication compliance subsystem.

  13. Factors Impacting On Patient Compliance with Medical Advice: Empirical Study

    Directory of Open Access Journals (Sweden)

    Krot Katarzyna

    2017-06-01

    Full Text Available The purpose of this paper to identify factors which have a bearing on compliance with medical advice in various age groups. The survey was conducted, using the CAWI method, on a representative sample of 1000 respondents who declared having used healthcare services in the previous six months. Control of competences is one of the strongest factors which is common for the oldest and youngest groups. Interestingly, trust in the integrity and honesty of doctors is significant for the youngest patients, i.e., the higher is the level of trust, the lower is the tendency to non-comply. Another type of trust is related to the benevolence of doctors and is significant to patients of the middle age group. Satisfaction is a significant predictor in the two oldest groups of patients. High levels of satisfaction seem to deter people from non-adherence to recommended treatment regimens. The results of the present study provide knowledge about the nature and diversity of factors behind patient compliance in various age groups.

  14. Compliance testing of medical diagnostic x-ray equipment: three years experience of a public hospital in western Australia

    International Nuclear Information System (INIS)

    Tuchyna, T.; Jacob, C.S.

    2000-01-01

    Full text: A formal compliance testing program which began on 1 January 1997 called for all medical and diagnostic x-ray equipment to be tested according to protocols established by the Western Australian Radiological Council. This work describes the impact of the legislation three years post implementation on a major teaching Hospital with 45 x-ray tubes located throughout 37 rooms. Testing is performed prior to scheduled service by licensed compliance testers according to test methods specified in the Western Australian Compliance Testing Workbook, 1997. A dedicated non-invasive x-ray beam analyser is instrumental in accurately determining radiation output parameters of the generator and x-ray tube. Assessment of compliance is determined by a Qualified Expert. Repair and re-testing of non-compliant items is coordinated with service personnel. Notices of non-compliance were received for approximately 60% of the equipment in the Hospital following the equipment' first annual test. Reasons and seriousness of failure varied according to equipment category, test category, equipment use and age. The majority of non-compliance issues were resolved within 90 days. At the end of the third year of testing, approximately 75% of the x-ray units tested met the compliance criteria. The main reasons for non-compliance were found to be design limitations associated with old technology and the current radiation legislation that makes it difficult for older equipment to meet the stringent criteria. The number and categories of failure did not significantly decrease in the second or third years of testing. Exemptions from compliance criteria have been sought for two units on the basis of age and design. Units unable to meet the criteria following several repair attempts or where the cost of repair was deemed not justified, were decommissioned. Formal testing of medical x-ray equipment has demonstrated various non-compliance issues that did not significantly improve during the

  15. Additional mailing phase for FIT after a medical offer phase: The best way to improve compliance with colorectal cancer screening in France.

    Science.gov (United States)

    Piette, Christine; Durand, Gérard; Bretagne, Jean-François; Faivre, Jean

    2017-03-01

    Compliance with colorectal cancer screening is critical to its effectiveness. The organisation of the mass screening programme in France has recently been modified with no evaluation of the consequences. To evaluate the impact of the way the screening test is delivered on compliance. During the first six months of the screening campaign (Ille-Vilaine, Brittany), general practitioners were asked to propose a faecal immunochemical test (FIT), OC-Sensor, to individuals at average risk for colorectal cancer (n=152,097). A subset of non-participants in the medical phase (n=13,071) was randomly chosen to receive a reminder that included the screening test or a simple postal reminder without the screening test. Compliance was 31% if the screening test was proposed during a medical consultation. In non-participants during the medical phase, it was 45% in those receiving both a reminder and the screening test and 28% amongst those receiving a simple reminder. An estimated overall participation rate of 54% can be expected if non-participants in the medical phase are sent a reminder together with the screening test. In France, a compliance rate above the minimum uptake rate of 45% recommended by European Union experts can be achieved if the FIT is mailed to non-participants after the medical free-offer phase. Copyright © 2016. Published by Elsevier Ltd.

  16. Year 2000 compliance issues.

    Science.gov (United States)

    1999-03-01

    This month, we continue our coverage of the year 2000 (Y2K) problem as it affects healthcare facilities and the professionals who work in them. We present the following articles: "Checking PCs for Y2K Compliance"--In this article, we describe the probable sources of Y2K-related errors in PCs and present simple procedures for testing the Y2K compliance of PCs and application software. "Y2K Assessment Equipment Expectations"--In this article, we review the Y2K compliance data from a small sampling of hospitals to help answer the question "What percentage of medical equipment will likely be susceptible to Y2K problems?" "Y2K Labeling of Medical Devices"--In this article, we discuss the pros and cons of instituting a program to label each medical device with its Y2K status. Also in this section, we present an updated list of organizations that support ECRI's Position Statement on the testing of medical devices for Y2K compliance, which we published in the December 1998 issue of Health Devices (27[12]). And we remind readers of the services ECRI can offer to help healthcare institutions cope with the Y2K problem.

  17. TU-AB-204-02: Device Adverse Events and Compliance

    International Nuclear Information System (INIS)

    Gonzales, S.

    2016-01-01

    The responsibilities of the Food and Drug Administration (FDA) have increased since the inception of the Food and Drugs Act in 1906. Medical devices first came under comprehensive regulation with the passage of the 1938 Food, Drug, and Cosmetic Act. In 1971 FDA also took on the responsibility for consumer protection against unnecessary exposure to radiation-emitting devices for home and occupational use. However it was not until 1976, under the Medical Device Regulation Act, that the FDA was responsible for the safety and effectiveness of medical devices. This session will be presented by the Division of Radiological Health (DRH) and the Division of Imaging, Diagnostics, and Software Reliability (DIDSR) from the Center for Devices and Radiological Health (CDRH) at the FDA. The symposium will discuss on how we protect and promote public health with a focus on medical physics applications organized into four areas: pre-market device review, post-market surveillance, device compliance, current regulatory research efforts and partnerships with other organizations. The pre-market session will summarize the pathways FDA uses to regulate the investigational use and commercialization of diagnostic imaging and radiation therapy medical devices in the US, highlighting resources available to assist investigators and manufacturers. The post-market session will explain the post-market surveillance and compliance activities FDA performs to monitor the safety and effectiveness of devices on the market. The third session will describe research efforts that support the regulatory mission of the Agency. An overview of our regulatory research portfolio to advance our understanding of medical physics and imaging technologies and approaches to their evaluation will be discussed. Lastly, mechanisms that FDA uses to seek public input and promote collaborations with professional, government, and international organizations, such as AAPM, International Electrotechnical Commission (IEC

  18. TU-AB-204-02: Device Adverse Events and Compliance

    Energy Technology Data Exchange (ETDEWEB)

    Gonzales, S. [Food & Drug Administration (United States)

    2016-06-15

    The responsibilities of the Food and Drug Administration (FDA) have increased since the inception of the Food and Drugs Act in 1906. Medical devices first came under comprehensive regulation with the passage of the 1938 Food, Drug, and Cosmetic Act. In 1971 FDA also took on the responsibility for consumer protection against unnecessary exposure to radiation-emitting devices for home and occupational use. However it was not until 1976, under the Medical Device Regulation Act, that the FDA was responsible for the safety and effectiveness of medical devices. This session will be presented by the Division of Radiological Health (DRH) and the Division of Imaging, Diagnostics, and Software Reliability (DIDSR) from the Center for Devices and Radiological Health (CDRH) at the FDA. The symposium will discuss on how we protect and promote public health with a focus on medical physics applications organized into four areas: pre-market device review, post-market surveillance, device compliance, current regulatory research efforts and partnerships with other organizations. The pre-market session will summarize the pathways FDA uses to regulate the investigational use and commercialization of diagnostic imaging and radiation therapy medical devices in the US, highlighting resources available to assist investigators and manufacturers. The post-market session will explain the post-market surveillance and compliance activities FDA performs to monitor the safety and effectiveness of devices on the market. The third session will describe research efforts that support the regulatory mission of the Agency. An overview of our regulatory research portfolio to advance our understanding of medical physics and imaging technologies and approaches to their evaluation will be discussed. Lastly, mechanisms that FDA uses to seek public input and promote collaborations with professional, government, and international organizations, such as AAPM, International Electrotechnical Commission (IEC

  19. Relationship of Personal- Social and Therapeutic Factors with Medication Compliance in TB Patients in Ahwaz

    Directory of Open Access Journals (Sweden)

    S Jahani

    2012-01-01

    Full Text Available Introduction: Despite the implementation of DOTS strategy, TB remains one of the ten leading causes of death in developing countries. Compliance with treatment is affected by social, cultural, and economic factors, and patients’ knowledge and attitude as well. The aim of this study was to determine the relationship between compliance with treatment and personal, social and therapeutic factors in TB patients in Ahwaz. Methods: This cross-sectional descriptive study was conducted on 167 TB patients. Subjects were selected based on target. The data were collected using a questionnaire, and by observation, sputum analysis, and Kvzart Ponce urine test. The validity of the questionnaire was tested by the method of content validity, and its internal consistency and reliability was tested by Cronbach's alpha coefficient. Data analyzed by SpSS. Results: Among all subjects, 52.7% of patients showed complete compliance and 35.2% and 12% of them showed partial and poor compliance, respectively. There was a significant relationship between treatment compliance and gender(p=0.009, quality of monthly income(p=0.007, and addiction(p=0.001. The quality of treatment compliance was not significantly related to age, marital status, educational level, ethnicity, and medical complications. Conclusion: The findings showed that Incomplete treatment of TB is much worse than not treating it, because the lack of precision in the administration and consumption of anti-tuberculosis drugs, leads to the emergence of resistant TB. Paying attention to the factors decreasing treatment compliance and trying to eliminate them may lead to better treatment and lower incidence and prevalence of tuberculosis in the community.

  20. MO-AB-201-03: The Alphabet Soup of Regulatory Compliance: Being Prepared for Inspections

    Energy Technology Data Exchange (ETDEWEB)

    Kroger, L. [University of California Davis (United States)

    2015-06-15

    The role of the Radiation Safety Officer at a medical facility can be complicated. The complexity of the position is based on the breadth of services provided at the institution and the nature of the radioactive materials license. Medical practices are constantly changing and the use of ionizing radiation continues to rise in this area. Some of the newer medical applications involving radiation have unique regulatory and safety issues that must be addressed. Oversight of the uses of radiation start at the local level (radiation safety officer, radiation safety committee) and are heavily impacted by outside agencies (i.e. Nuclear Regulatory Commission, State Radiologic Health, The Joint Commission (TJC), etc). This session will provide both an overview of regulatory oversight and essential compliance practices as well as practical ways to assess and introduce some of the new applications utilizing radioactive materials into your medical facility. Learning Objectives: Regulatory Compliance and Safety with New Radiotherapies: Spheres and Ra-223 (Lance Phillips) Understand the radioactive materials license amendment process to add new radiotherapies (i.e., SIR-Spheres, Therasphere, Xofigo). Understand the AU approval process for microspheres and Xofigo. Examine the training and handling requirements for new procedures. Understand the process involved with protocol development, SOP in order to define roles and responsibilities. The RSO and The RSC: Challenges and Opportunities (Colin Dimock) Understand how to form an effective Committee. Examine what the Committee does for the Program and the RSO. Understand the importance of Committee engagement. Discuss the balance of the complimentary roles of the RSO and the Committee. The Alphabet Soup of Regulatory Compliance: Being Prepared for Inspections (Linda Kroger) Recognize the various regulatory bodies and organizations with oversight or impact in Nuclear Medicine, Radiology and Radiation Oncology. Examine 10CFR35

  1. MO-AB-201-03: The Alphabet Soup of Regulatory Compliance: Being Prepared for Inspections

    International Nuclear Information System (INIS)

    Kroger, L.

    2015-01-01

    The role of the Radiation Safety Officer at a medical facility can be complicated. The complexity of the position is based on the breadth of services provided at the institution and the nature of the radioactive materials license. Medical practices are constantly changing and the use of ionizing radiation continues to rise in this area. Some of the newer medical applications involving radiation have unique regulatory and safety issues that must be addressed. Oversight of the uses of radiation start at the local level (radiation safety officer, radiation safety committee) and are heavily impacted by outside agencies (i.e. Nuclear Regulatory Commission, State Radiologic Health, The Joint Commission (TJC), etc). This session will provide both an overview of regulatory oversight and essential compliance practices as well as practical ways to assess and introduce some of the new applications utilizing radioactive materials into your medical facility. Learning Objectives: Regulatory Compliance and Safety with New Radiotherapies: Spheres and Ra-223 (Lance Phillips) Understand the radioactive materials license amendment process to add new radiotherapies (i.e., SIR-Spheres, Therasphere, Xofigo). Understand the AU approval process for microspheres and Xofigo. Examine the training and handling requirements for new procedures. Understand the process involved with protocol development, SOP in order to define roles and responsibilities. The RSO and The RSC: Challenges and Opportunities (Colin Dimock) Understand how to form an effective Committee. Examine what the Committee does for the Program and the RSO. Understand the importance of Committee engagement. Discuss the balance of the complimentary roles of the RSO and the Committee. The Alphabet Soup of Regulatory Compliance: Being Prepared for Inspections (Linda Kroger) Recognize the various regulatory bodies and organizations with oversight or impact in Nuclear Medicine, Radiology and Radiation Oncology. Examine 10CFR35

  2. [Drug compliance of patients on anticoagulant treatment].

    Science.gov (United States)

    Gadó, Klára; Kocsis, Eszter; Zelkó, Romána; Hankó, Balázs; Kovácsné Balogh, Judit; Forczig, Mónika; Domján, Gyula

    2015-08-09

    Despite several therapeutic possibilities the morbidity and mortality of thromboembolic disorders remain high. Improving drug compliance - i. e. keeping up the doctor's prescriptions - may be an effective tool to reach better results. To improve patients' compliance, the risk factors of non-compliance should be recognized. Among these patients' fear of adverse effects of drugs, their lack of knowledge about their illness and medication, forgetfulness, and other social, economic factors may be the most important. Furthermore, adherence may be worsened when the patient feels that the decision has been made over his/her head. Sustained medical adherence is important because anticoagulation may be a life-long treatment. The new oral anticoagulants make the matter of compliance to be current. These new type of drugs do not need regular laboratory monitoring and, therefore, compliance cannot be strictly followed. There are several studies concerning drug compliance to anticoagulant medications. Improvement of adherence is based on regular patient education after reviewing the factors of non-compliance, which needs teamwork with important roles of doctors, pharmacists, dietetics and nurses. Careful and accurate work of the participants of primary care might be complemented by the activity of anticoagulant clinics.

  3. Using Social Cognitive Theory to Predict Medication Compliance Behavior in Patients with Depression in Southern United States in 2016 in a Cross-Sectional Study.

    Science.gov (United States)

    Bennett, Britney; Sharma, Manoj; Bennett, Russell; Mawson, Anthony R; Buxbaum, Sarah G; Sung, Jung Hye

    2018-03-01

    Introduction: Depression is a major public health issue. One of the concerns in depression research and practice pertains to non-compliance to prescribed medications. The purpose of the study was to predict compliance with medication use for patients with depression using social cognitive theory (SCT). Based on this study it was envisaged that recommendations for interventions to enhance compliance for medication use could be developed for patients with depression. Methods: The study was conducted using cross sectional design (n=148) in southern United States with a convenience sample of clinic-based depression patients with a 37-item valid and reliable questionnaire. Sample size was calculated to be 148 using G*Power (five predictors with a 0.80 power at the 0.05 alpha level and an estimated effect size of 0.10 with an inflation by 10% for missing data). Social cognitive theory constructs of expectations, self-efficacy and self-efficacy in overcoming barriers, self-control, and environment were reified. Data were analyzed using multiple linear regression and multiple logistic regression analyses. Results: Self-control for taking medication for depression (P=0.04), expectations for taking medication for depression (P=0.025), age (P<0.0001) and race (P=0.04) were significantly related to intent for taking medication for depression (Adjusted R 2 = 0.183). In race, Blacks had lower intent to take medication for depression. Conclusion: Social cognitive theory is weakly predictive with low explained variance for taking medication for depression. It needs to be bolstered by newer theories like integrative model or multi-theory model of health behavior change for designing educational interventions aimed at enhancing compliance to medication for depression.

  4. Using Social Cognitive Theory to Predict Medication Compliance Behavior in Patients with Depression in Southern United States in 2016 in a Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Britney Bennett

    2018-03-01

    Full Text Available Introduction: Depression is a major public health issue. One of the concerns in depression research and practice pertains to non-compliance to prescribed medications. The purpose of the study was to predict compliance with medication use for patients with depression using social cognitive theory (SCT. Based on this study it was envisaged that recommendations for interventions to enhance compliance for medication use could be developed for patients with depression. Methods: The study was conducted using cross sectional design (n=148 in southern United States with a convenience sample of clinic-based depression patients with a 37-item valid and reliable questionnaire. Sample size was calculated to be 148 using G*Power (five predictors with a 0.80 power at the 0.05 alpha level and an estimated effect size of 0.10 with an inflation by 10% for missing data. Social cognitive theory constructs of expectations, self-efficacy and self-efficacy in overcoming barriers, self-control, and environment were reified. Data were analyzed using multiple linear regression and multiple logistic regression analyses. Results: Self-control for taking medication for depression (P=0.04, expectations for taking medication for depression (P=0.025, age (P<0.0001 and race (P=0.04 were significantly related to intent for taking medication for depression (Adjusted R2 = 0.183. In race, Blacks had lower intent to take medication for depression. Conclusion: Social cognitive theory is weakly predictive with low explained variance for taking medication for depression. It needs to be bolstered by newer theories like integrative model or multi-theory model of health behavior change for designing educational interventions aimed at enhancing compliance to medication for depression.

  5. Patient compliance with exercise: different theoretical approaches to short-term and long-term compliance.

    NARCIS (Netherlands)

    Sluijs, E.M.; Knibbe, J.J.

    1991-01-01

    Compliance with exercise regimens is difficult to obtain as is compliance with other medical regimens. In analyzing noncompliance, two problems exist: (I) current theories only partly explain patients’ noncompliance; (2) health care providers seldom act according to the recommendations derived from

  6. Using the Theory of Normative Social Behavior to Understand Compliance with a Smoke-Free Law in a Middle-Income Country

    Science.gov (United States)

    Byron, M. J.; Cohen, J. E.; Frattaroli, S.; Gittelsohn, J.; Jernigan, D. H.

    2016-01-01

    Smoke-free laws, which ban smoking in public venues, can be effective in protecting public health, but it has been difficult to achieve compliance with these laws in low- and middle-income countries. This study was conducted to understand the social norms around public smoking and learn how to improve compliance in Bogor, the first Indonesian city…

  7. MO-AB-201-01: Regulatory Compliance and Safety with New Radiotherapies: Spheres and Ra-223

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, L. [Stanford University (United States)

    2015-06-15

    The role of the Radiation Safety Officer at a medical facility can be complicated. The complexity of the position is based on the breadth of services provided at the institution and the nature of the radioactive materials license. Medical practices are constantly changing and the use of ionizing radiation continues to rise in this area. Some of the newer medical applications involving radiation have unique regulatory and safety issues that must be addressed. Oversight of the uses of radiation start at the local level (radiation safety officer, radiation safety committee) and are heavily impacted by outside agencies (i.e. Nuclear Regulatory Commission, State Radiologic Health, The Joint Commission (TJC), etc). This session will provide both an overview of regulatory oversight and essential compliance practices as well as practical ways to assess and introduce some of the new applications utilizing radioactive materials into your medical facility. Learning Objectives: Regulatory Compliance and Safety with New Radiotherapies: Spheres and Ra-223 (Lance Phillips) Understand the radioactive materials license amendment process to add new radiotherapies (i.e., SIR-Spheres, Therasphere, Xofigo). Understand the AU approval process for microspheres and Xofigo. Examine the training and handling requirements for new procedures. Understand the process involved with protocol development, SOP in order to define roles and responsibilities. The RSO and The RSC: Challenges and Opportunities (Colin Dimock) Understand how to form an effective Committee. Examine what the Committee does for the Program and the RSO. Understand the importance of Committee engagement. Discuss the balance of the complimentary roles of the RSO and the Committee. The Alphabet Soup of Regulatory Compliance: Being Prepared for Inspections (Linda Kroger) Recognize the various regulatory bodies and organizations with oversight or impact in Nuclear Medicine, Radiology and Radiation Oncology. Examine 10CFR35

  8. MO-AB-201-01: Regulatory Compliance and Safety with New Radiotherapies: Spheres and Ra-223

    International Nuclear Information System (INIS)

    Phillips, L.

    2015-01-01

    The role of the Radiation Safety Officer at a medical facility can be complicated. The complexity of the position is based on the breadth of services provided at the institution and the nature of the radioactive materials license. Medical practices are constantly changing and the use of ionizing radiation continues to rise in this area. Some of the newer medical applications involving radiation have unique regulatory and safety issues that must be addressed. Oversight of the uses of radiation start at the local level (radiation safety officer, radiation safety committee) and are heavily impacted by outside agencies (i.e. Nuclear Regulatory Commission, State Radiologic Health, The Joint Commission (TJC), etc). This session will provide both an overview of regulatory oversight and essential compliance practices as well as practical ways to assess and introduce some of the new applications utilizing radioactive materials into your medical facility. Learning Objectives: Regulatory Compliance and Safety with New Radiotherapies: Spheres and Ra-223 (Lance Phillips) Understand the radioactive materials license amendment process to add new radiotherapies (i.e., SIR-Spheres, Therasphere, Xofigo). Understand the AU approval process for microspheres and Xofigo. Examine the training and handling requirements for new procedures. Understand the process involved with protocol development, SOP in order to define roles and responsibilities. The RSO and The RSC: Challenges and Opportunities (Colin Dimock) Understand how to form an effective Committee. Examine what the Committee does for the Program and the RSO. Understand the importance of Committee engagement. Discuss the balance of the complimentary roles of the RSO and the Committee. The Alphabet Soup of Regulatory Compliance: Being Prepared for Inspections (Linda Kroger) Recognize the various regulatory bodies and organizations with oversight or impact in Nuclear Medicine, Radiology and Radiation Oncology. Examine 10CFR35

  9. Continuing Medical Education Improves Gastroenterologists' Compliance with Inflammatory Bowel Disease Quality Measures.

    Science.gov (United States)

    Sapir, Tamar; Moreo, Kathleen; Carter, Jeffrey D; Greene, Laurence; Patel, Barry; Higgins, Peter D R

    2016-07-01

    Low rates of compliance with quality measures for inflammatory bowel disease (IBD) have been reported for US gastroenterologists. We assessed the influence of quality improvement (QI) education on compliance with physician quality reporting system (PQRS) measures for IBD and measures related to National Quality Strategy (NQS) priorities. Forty community-based gastroenterologists participated in the QI study; 20 were assigned to educational intervention and control groups, respectively. At baseline, randomly selected charts of patients with moderate-to-severe ulcerative colitis were retrospectively reviewed for the gastroenterologists' performance of 8 PQRS IBD measures and 4 NQS-related measures. The intervention group participated in a series of accredited continuing medical education (CME) activities focusing on QI. Follow-up chart reviews were conducted 6 months after the CME activities. Independent t tests were conducted to compare between-group differences in baseline-to-follow-up rates of documented compliance with each measure. The analysis included 299 baseline charts and 300 follow-up charts. The intervention group had significantly greater magnitudes of improvement than the control group for the following measures: assessment of IBD type, location, and activity (+14 %, p = 0.009); influenza vaccination (+13 %, p = 0.025); pneumococcal vaccination (+20 %, p = 0.003); testing for latent tuberculosis before anti-TNF-α therapy (+10 %, p = 0.028); assessment of hepatitis B virus status before anti-TNF-α therapy (+9 %, p = 0.010); assessment of side effects (+17 %, p = 0.048), and counseling patients about cancer risks (+13 %, p = 0.013). QI-focused CME improves community-based gastroenterologists' compliance with IBD quality measures and measures aligned with NQS priorities.

  10. Influence of social competence of physicians on patient compliance with osteoporosis medications--a study on Polish postmenopausal women.

    Science.gov (United States)

    Bryl, Nadia; Horst-Sikorska, Wanda; Ignaszak-Szczepaniak, Magdalena; Marcinkowska, Michalina; Michalak, Michał; Sewerynek, Ewa

    2012-07-01

    The aim of the study was to examine the impact of social competence of physicians on the effectiveness of patient compliance and persistence with therapy. The study included physicians and their patients, previously diagnosed with osteoporosis, and eligible to receive pharmacological treatment. The physicians were evaluated with the social competence questionnaire involving three dimensions: social exposure, intimacy and assertiveness, as well as in the combined scale. All patients in the study group were prescribed the same medication: alendronate once a week. Compliance and persistence of the patients were juxtaposed with social interaction skills of physicians during 7 scheduled appointments at 2-month intervals. Doctor's effectiveness in situations demanding close interpersonal contact was higher in the group with good compliance--group A (p fear and

  11. Compliance and treatment satisfaction of post menopausal women treated for osteoporosis. Compliance with osteoporosis treatment

    Directory of Open Access Journals (Sweden)

    Huas Dominique

    2010-08-01

    Full Text Available Abstract Background Adherence to anti-osteoporosis treatments is poor, exposing treated women to increased fracture risk. Determinants of poor adherence are poorly understood. The study aims to determine physician- and patient- rated treatment compliance with osteoporosis treatments and to evaluate factors influencing compliance. Methods This was an observational, cross-sectional pharmacoepidemiological study with a randomly-selected sample of 420 GPs, 154 rheumatologists and 110 gynaecologists practicing in France. Investigators included post-menopausal women with a diagnosis of osteoporosis and a treatment initiated in the previous six months. Investigators completed a questionnaire on clinical features, treatments and medical history, and on patient compliance. Patients completed a questionnaire on sociodemographic features, lifestyle, attitudes and knowledge about osteoporosis, treatment compliance, treatment satisfaction and quality of life. Treatment compliance was evaluated with the Morisky Medication-taking Adherence Scale. Variables collected in the questionnaires were evaluated for association with compliance using multivariate logistic regression analysis. Results 785 women were evaluated. Physicians considered 95.4% of the sample to be compliant, but only 65.5% of women considered themselves compliant. The correlation between patient and physician perceptions of compliance was low (κ: 0.11 [95% CI: 0.06 to 0.16]. Patient-rated compliance was highest for monthly bisphosphonates (79.7% and lowest for hormone substitution therapy (50.0%. Six variables were associated with compliance: treatment administration frequency, perceptions of long-term treatment acceptability, perceptions of health consequences of osteoporosis, perceptions of knowledge about osteoporosis, exercise and mental quality of life. Conclusion Compliance to anti-osteoporosis treatments is poor. Reduction of dosing regimen frequency and patient education may be useful

  12. Irish medical students’ understanding of the intern year

    LENUS (Irish Health Repository)

    Gouda, P,

    2016-03-01

    Upon completion of medical school in Ireland, graduates must make the transition to becoming interns. The transition into the intern year may be described as challenging as graduates assume clinical responsibilities. Historically, a survey of interns in 1996 found that 91% felt unprepared for their role. However, recent surveys in 2012 have demonstrated that this is changing with preparedness rates reaching 52%. This can be partially explained by multiple initiatives at the local and national level. Our study aimed evaluate medical student understanding of the intern year and associated factors. An online, cross-sectional survey was sent out to all Irish medical students in 2013 and included questions regarding their understanding of the intern year. Two thousand, two hundred and forty-eight students responded, with 1224 (55.4%) of students agreeing or strongly agreeing that they had a good understanding of what the intern year entails. This rose to 485 (73.7%) among senior medical students. Of junior medical students, 260 (42.8%) indicated they understood what the intern year, compared to 479 (48.7%) of intermediate medical students. Initiatives to continue improving preparedness for the intern year are essential in ensuring a smooth and less stressful transition into the medical workforce

  13. Oral anticancer agent medication adherence by outpatients.

    Science.gov (United States)

    Kimura, Michio; Usami, Eiseki; Iwai, Mina; Nakao, Toshiya; Yoshimura, Tomoaki; Mori, Hiromi; Sugiyama, Tadashi; Teramachi, Hitomi

    2014-11-01

    In the present study, medication adherence and factors affecting adherence were examined in patients taking oral anticancer agents. In June 2013, 172 outpatients who had been prescribed oral anticancer agents by Ogaki Municipal Hospital (Ogaki, Gifu, Japan) completed a questionnaire survey, with answers rated on a five-point Likert scale. The factors that affect medication adherence were evaluated using a customer satisfaction (CS) analysis. For patients with good and insufficient adherence to medication, the median ages were 66 years (range, 21-85 years) and 73 years (range, 30-90 years), respectively (P=0.0004), while the median dosing time was 131 days (range, 3-3,585 days) and 219 days (24-3,465 days), respectively (P=0.0447). In 36.0% (62 out of 172) of the cases, there was insufficient medication adherence; 64.5% of those cases (40 out of 62) showed good medication compliance (4-5 point rating score). However, these patients did not fully understand the effects or side-effects of the drugs, giving a score of three points or less. The percentage of patients with good medication compliance was 87.2% (150 out of 172). Through the CS analysis, three items, the interest in the drug, the desire to consult about the drug and the condition of the patient, were extracted as items for improvement. Overall, the medication compliance of the patients taking the oral anticancer agents was good, but the medication adherence was insufficient. To improve medication adherence, a better understanding of the effectiveness and necessity of drugs and their side-effects is required. In addition, the interest of patients in their medication should be encouraged and intervention should be tailored to the condition of the patient. These steps should lead to improved medication adherence.

  14. Mapping Tax Compliance

    DEFF Research Database (Denmark)

    Boll, Karen

    2014-01-01

    Tax compliance denotes the act of reporting and paying taxes in accordance with the tax laws. Current social science scholarship on tax compliance can almost entirely be divided into behavioural psychology analyses and critical tax studies. This article, which presents two cases of how tax...... compliance is constructed, challenges the explanatory reaches of today's social science approaches, arguing that an alternative approach to understanding tax compliance is worthwhile exploring. This other choice of approach, inspired by actor–network theory (ANT), adopts a more practice-oriented focus...... that studies tax compliance where it takes place as well as what it is made of. Consequently, this article argues that tax compliance is a socio-material assemblage and that complying is a distributed action. The article concludes by highlighting how an ANT approach contributes to the further theoretical...

  15. Physician Verbal Compliance-Gaining Strategies and Patient Satisfaction

    Science.gov (United States)

    Olynick, Janna; Iliopulos, Alexandra; Li, Han Z.

    2017-01-01

    Purpose: The patient healthcare experience is a complex phenomenon, as is encouraging patient compliance with medical advice. To address this multifaceted relationship, the purpose of this paper is to explore the ways resident physicians verbally encourage patient compliance and the relationship between these compliance-seeking strategies and…

  16. Regulatory Enforcement and Compliance

    DEFF Research Database (Denmark)

    May, Peter J.; Winter, Søren

    1999-01-01

    This study of municipal enforcement of agro-environmental regulations in Denmark provides an empirical understanding of how enforcement affects compliance. A key contribution is sorting out the relative influence of inspectors' different styles of enforcement and choices made by enforcement...... agencies. The latter are shown to be more important in bringing about compliance than are inspectors' enforcement styles. Municipal agencies are shown to increase compliance through the use of third parties, more frequent inspection, and setting priorities for inspection of major items. The findings about...

  17. Compliance with therapy in children with respiratory diseases.

    Science.gov (United States)

    Schöni, M H; Horak, E; Nikolaizik, W H

    1995-01-01

    Compliance with medical treatment was evaluated in 89 children and adolescents with respiratory diseases using two methods of assessment: a double blinded covert recording of the use of an air compressor for nebulization of drugs and the determination of theophylline levels in serum. In the covert monitoring of inhalation the overall compliance with the prescribed medication was 47.6%. In the open randomized theophylline trial, 56%-71% of the patients (according to uncontrolled or controlled intake of the drug) received a dosage of theophylline which was too low to achieve a sufficient serum level in the range of 10-20 mg/l. This, however, was also due to the fact that in 72% of the cases physicians prescribed doses which were substantially below the recommended amount of drug according to age and weight. It is, therefore, concluded that compliance of medication is based on the patients adherence to the medication, to the efficacy of the drug itself and the attitude of the physician.

  18. Systematic evaluation of "compliance" to prescribed treatment medications and "abstinence" from psychoactive drug abuse in chemical dependence programs: data from the comprehensive analysis of reported drugs.

    Science.gov (United States)

    Blum, Kenneth; Han, David; Femino, John; Smith, David E; Saunders, Scott; Simpatico, Thomas; Schoenthaler, Stephen J; Oscar-Berman, Marlene; Gold, Mark S

    2014-01-01

    This is the first quantitative analysis of data from urine drug tests for compliance to treatment medications and abstinence from drug abuse across "levels of care" in six eastern states of America. Comprehensive Analysis of Reported Drugs (CARD) data was used in this post-hoc retrospective observational study from 10,570 patients, filtered to include a total of 2,919 patients prescribed at least one treatment medication during 2010 and 2011. The first and last urine samples (5,838 specimens) were analyzed; compliance to treatment medications and abstinence from drugs of abuse supported treatment effectiveness for many. Compared to non-compliant patients, compliant patients were marginally less likely to abuse opioids, cannabinoids, and ethanol during treatment although more likely to abuse benzodiazepines. Almost 17% of the non-abstinent patients used benzodiazepines, 15% used opiates, and 10% used cocaine during treatment. Compliance was significantly higher in residential than in the non-residential treatment facilities. Independent of level of care, 67.2% of the patients (n = 1963; Pabuse detected in either the first or last urine samples (abstinence). Moreover, in 2010, 16.9% of the patients (n = 57) were abstinent at first but not at last urine (deteriorating abstinence), the percentage dropped to 13.3% (n = 174) in 2011; this improvement over years was statistically significant. A longitudinal analysis for abstinence and compliance was studied in a randomized subset from 2011, (n = 511) representing 17.5% of the total cohort. A statistically significant upward trend (p = 2.353×10-8) of abstinence rates as well as a similar but stronger trend for compliance ((p = 2.200×10-16) was found. Being cognizant of the trend toward drug urine testing being linked to medical necessity eliminating abusive screening, the interpretation of these valuable results require further intensive investigation.

  19. Compliance Performance: Effects of a Provider Incentive Program and Coding Compliance Plan

    National Research Council Canada - National Science Library

    Tudela, Joseph A

    2004-01-01

    The purpose of this project is to study provider and coder related performance, i.e., provider compliance rate and coder productivity/accuracy rates and average dollar difference between coder and auditor, at Brooke Army Medical Center...

  20. Transcript for Understanding Medical Words: A Tutorial

    Science.gov (United States)

    ... medlineplus.gov/medicalwordstranscript.html Transcript for Understanding Medical Words: A Tutorial To use the sharing features on ... get to what those mean in a minute. Word Roots Word Roots. Let's begin with body parts. ...

  1. Analysis of variables affecting drug compliance in schizophrenia

    Directory of Open Access Journals (Sweden)

    Shakeel Ansari

    2014-01-01

    Full Text Available Context: As compliance of the patient during management of schizophrenia is crucial, the current study was conducted to find out the factors that affected compliance. Aims: The aim of the study was to analyze the prevalence of noncompliance and to find out different factors affecting compliance in schizophrenic patients. Materials and Methods: Observational cross-sectional study was conducted on 100 adult schizophrenic patients. Noncompliance was assessed using the rating of medication influence (ROMI scale. Severity of illness was measured using positive and negative syndrome scale (PANSS. Results: Prevalence of noncompliance was 37%. Using ROMI scale; positive relationship with psychiatrist, family pressure for taking medications, stigma, and substance abuse were found to be significant factors. Severity of illness was also found as determining factor. Conclusion: To improve the compliance in schizophrenia patients, roles of both psychiatrists and family members are crucial.

  2. Serum potassium monitoring for users of ethinyl estradiol/drospirenone taking medications predisposing to hyperkalemia: physician compliance and survey of knowledge and attitudes.

    Science.gov (United States)

    Mona Eng, Patricia; Seeger, John D; Loughlin, Jeanne; Oh, Kelly; Walker, Alexander M

    2007-02-01

    Yasmin-28 [ethinyl estradiol 0.03 mg/drospirenone 3 mg (EE/DRSP)] contains drospirenone, a progestin component that possesses antimineralocorticoid activity with a potassium-sparing diuretic effect similar to that in spironolactone. Product labeling recommends potassium monitoring in the first month of use for women concurrently receiving medication that may increase serum potassium. We evaluated compliance with this recommendation by measuring monitoring around the date of oral contraceptive (OC) initiation in women who received EE/DRSP while being treated with medications predisposing to hyperkalemia and in similar women who received other OCs. Because preliminary analyses indicated incomplete compliance, we surveyed physicians who prescribed EE/DRSP to women receiving drugs predisposing to hyperkalemia on their knowledge and attitudes with regard to the recommendation. We conducted this study using data from the Ingenix Research Datamart, which includes insurance claims for reimbursement for medical services and prescription medications for approximately 8,000,000 members of a large nationally dispersed health plan. We used claims for pharmacy dispensings of prescription medications to identify all women aged 10-59 years old who initiated EE/DRSP or other OCs during the first 3 years of EE/DRSP availability (July 2001 to June 2004). The frequency of potassium monitoring was measured by identifying claims for serum potassium tests. We conducted a telephone survey of 58 physicians who had prescribed EE/DRSP up to June 2003 to women who received concomitant hyperkalemic drugs. Although potassium monitoring was generally more frequent among EE/DRSP initiators receiving concomitant hyperkalemic drugs than among other OC initiators receiving similar medications, only 40% of 466 EE/DRSP initiators with concurrent hyperkalemic treatment had potassium tests. More than 98% of surveyed physicians were aware of the potassium-sparing property of EE/DRSP. Compared with

  3. Understanding Patients’ Process to Use Medical Marijuana

    Directory of Open Access Journals (Sweden)

    Tara L Crowell

    2016-09-01

    Full Text Available Given the necessity to better understand the process patients need to go through in order to seek treatment via medical marijuana, this study investigates this process to better understand this phenomenon. Specifically, Compassion Care Foundation (CCF and Stockton University worked together to identify a solution to this problem. Specifically, 240 new patients at CCF were asked to complete a 1-page survey regarding various aspects associated with their experience prior to their use of medicinal marijuana—diagnosis, what prompted them to seek treatment, level of satisfaction with specific stages in the process, total length of time the process took, and patient’s level of pain. Results reveal numerous patient diagnoses for which medical marijuana is being prescribed; the top 4 most common are intractable skeletal spasticity, chronic and severe pain, multiple sclerosis, and inflammatory bowel disease. Next, results indicate a little over half of the patients were first prompted to seek alternative treatment from their physicians, while the remaining patients indicated that other sources such as written information along with friends, relatives, media, and the Internet persuaded them to seek treatment. These data indicate that a variety of sources play a role in prompting patients to seek alternative treatment and is a critical first step in this process. Additional results posit that once patients began the process of qualifying to receive medical marijuana as treatment, the process seemed more positive even though it takes patients on average almost 6 months to obtain their first treatment after they started the process. Finally, results indicate that patients are reporting a moderately high level of pain prior to treatment. Implication of these results highlights several important elements in the patients’ initial steps toward seeking medical marijuana, along with the quality and quantity of the process patients must engage in prior to

  4. Outsourcing your medical practice call center: how to choose a vendor to ensure regulatory compliance.

    Science.gov (United States)

    Johnson, Bill

    2014-01-01

    Medical practices receive hundreds if not thousands of calls every week from patients, payers, pharmacies, and others. Outsourcing call centers can be a smart move to improve efficiency, lower costs, improve customer care, ensure proper payer management, and ensure regulatory compliance. This article discusses how to know when it's time to move to an outsourced call center, the benefits of making the move, how to choose the right call center, and how to make the transition. It also provides tips on how to manage the call center to ensure the objectives are being met.

  5. Management of Older Inpatients Who Refuse Nonpsychiatric Medication Within Birmingham and Solihull Mental Health NHS Foundation Trust: Audit.

    Science.gov (United States)

    Umotong, Eno

    2016-12-01

    The effects of poor medication compliance are well documented and include increased morbidity, early mortality, and financial costs to the society. According to national guidelines, when a competent patient refuses medication, the doctor on duty has a responsibility to ensure the patient understands their proposed course of action. The aims of this audit were to evaluate whether this consultation was taking place within older in-patient units across Birmingham and Solihull Mental Health NHS Foundation Trust when patients refuse nonpsychiatric medicines. Poor compliance was defined as more than five refusals of a nonpsychiatric medication over a 4-week period. A discussion with the duty doctor occurred in 75% of cases (27/36), which resulted in a change in prescription or compliance in 59% (16/27 patients). After patient refusal of medication, a consultation with the duty doctor is likely to improve compliance and uncover salient issues particularly in regards to capacity and drug suitability.

  6. Understanding Patients? Process to Use Medical Marijuana

    OpenAIRE

    Crowell, Tara L

    2016-01-01

    Given the necessity to better understand the process patients need to go through in order to seek treatment via medical marijuana, this study investigates this process to better understand this phenomenon. Specifically, Compassion Care Foundation (CCF) and Stockton University worked together to identify a solution to this problem. Specifically, 240 new patients at CCF were asked to complete a 1-page survey regarding various aspects associated with their experience prior to their use of medici...

  7. Factors Affecting Compliance to Antihypertensive Treatment among Adults in a Tertiary Care Hospital in Mumbai.

    Science.gov (United States)

    Shah, Ayushi Jayesh; Singh, Vijaykumar; Patil, Subita P; Gadkari, Mithila R; Ramchandani, Varun; Doshi, Karan Janak

    2018-01-01

    Compliance to antihypertensive therapy reduces the risk of complications. It is important to understand the factors affecting compliance in patients so that the goal of successful treatment is not jeopardized. To determine the proportion of participants' compliant to treatment and various factors associated with compliance of antihypertensive treatment. A cross-sectional study of 330 hypertensive patients on treatment attending the outpatient department of a tertiary care hospital in Mumbai. It was conducted over 8 weeks using a validated, pretested questionnaire including information on the individual's sociodemographic profile, compliance to antihypertensive therapy and lifestyle advice assessed using a 4-point Likert scale. Data were entered into MS Excel 2007 and analyzed using SPSS 20. Participants' mean age was 55.2 ± 12.6 years. 39.4% were compliant to their treatment. Common reasons for frequently skipping the dose - forgetfulness (41.2%) and discontinued the medication when feeling well (30.3%). Factors positively associated with compliance were gender and illiteracy. The proportion of noncompliance among smokers and alcoholics was statistically significant. Forgetfulness and subjective feeling of wellness were the prevalent reasons for noncompliance. Controlling habits such as smoking and alcohol may prove as key factors for compliance.

  8. Exploring the usage of a mobile phone application in transplanted patients to encourage medication compliance and education.

    Science.gov (United States)

    Zanetti-Yabur, Alana; Rizzo, Amanda; Hayde, Nicole; Watkins, Anthony C; Rocca, Juan P; Graham, Jay A

    2017-10-01

    Medication non-adherence in transplant patients is a grave problem that results in increased rejection episodes, graft loss and significant morbidity. The efficacy of users and non-users of a mobile phone application (mobile app) in promoting medication adherence was investigated. The Beliefs about Medicine Questionnaire (BMQ) and Morisky Medication Adherence Scale (MMAS-8) were used in these cohorts to assess the predilection for poor adherence. Serum tacrolimus, creatinine levels, and rejection episodes were also recorded. Lastly, the patients were tested on their recall of their immunosuppression. Overall, patients had extremely negative beliefs about medication reflected in their tendency toward higher predicted rates of non-adherence. Interestingly, though not significant, app users had higher rates of medication recollection. The high-risk nature of this population demands efforts to abrogate non-adherence. Caregivers are charged with the responsibility to offer patients a feasible option to safeguard treatment compliance. Mobile apps are a potentially powerful tool, which can be used to decrease non-adherence. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Compliance Issues in Higher Education

    Science.gov (United States)

    Benedek, Petra

    2016-01-01

    Efficiency in the 1980's, quality in the 1990's, compliance in the 2010's - private sector management techniques and mechanisms find their way to public services. This paper facilitates the understanding of how compliance management controls can improve operations and prevent or detect failure or wrong doing. The last few years' empirical research…

  10. Compliance Framing - Framing Compliance

    OpenAIRE

    Lutz-Ulrich Haack; Martin C. Reimann

    2012-01-01

    Corporations have to install various organizational measures to comply with legal as well as internal guidelines systematically. Compliance management systems have the challenging task to make use of an internal compliance-marketing approach in order to ensure not only an adequate but also effective compliance-culture. Compliance-literature and findings of persuasive goal-framing-theory give opposite implications for establishing a rather values- versus rule-based compliance-culture respectiv...

  11. Factors affecting compliance to antihypertensive treatment among adults in a tertiary care hospital in Mumbai

    Directory of Open Access Journals (Sweden)

    Ayushi Jayesh Shah

    2018-01-01

    Full Text Available Background: Compliance to antihypertensive therapy reduces the risk of complications. It is important to understand the factors affecting compliance in patients so that the goal of successful treatment is not jeopardized. Objectives: To determine the proportion of participants' compliant to treatment and various factors associated with compliance of antihypertensive treatment. Settings and Design: A cross-sectional study of 330 hypertensive patients on treatment attending the outpatient department of a tertiary care hospital in Mumbai. Subjects and Methods: It was conducted over 8 weeks using a validated, pretested questionnaire including information on the individual's sociodemographic profile, compliance to antihypertensive therapy and lifestyle advice assessed using a 4-point Likert scale. Statistical Analysis: Data were entered into MS Excel 2007 and analyzed using SPSS 20. Results: Participants' mean age was 55.2 ± 12.6 years. 39.4% were compliant to their treatment. Common reasons for frequently skipping the dose – forgetfulness (41.2% and discontinued the medication when feeling well (30.3%. Factors positively associated with compliance were gender and illiteracy. The proportion of noncompliance among smokers and alcoholics was statistically significant. Conclusion: Forgetfulness and subjective feeling of wellness were the prevalent reasons for noncompliance. Controlling habits such as smoking and alcohol may prove as key factors for compliance.

  12. Patient compliance in hypertension: role of illness perceptions and treatment beliefs.

    Science.gov (United States)

    Ross, S; Walker, A; MacLeod, M J

    2004-09-01

    Despite many years of study, questions remain about why patients do or do not take medicines and what can be done to change their behaviour. Hypertension is poorly controlled in the UK and poor compliance is one possible reason for this. Recent questionnaires based on the self-regulatory model have been successfully used to assess illness perceptions and beliefs about medicines. This study was designed to describe hypertensive patients' beliefs about their illness and medication using the self-regulatory model and investigate whether these beliefs influence compliance with antihypertensive medication. We recruited 514 patients from our secondary care population. These patients were asked to complete a questionnaire that included the Beliefs about Medicines and Illness Perception Questionnaires. A case note review was also undertaken. Analysis shows that patients who believe in the necessity of medication are more likely to be compliant (odds ratio (OR)) 3.06 (95% CI 1.74-5.38), Pcompliance influence it indirectly. The self-regulatory model is useful in assessing patients health beliefs. Beliefs about specific medications and about hypertension are predictive of compliance. Information about health beliefs is important in achieving concordance and may be a target for intervention to improve compliance.

  13. Regulatory Compliance to Assure the Safety of the Operation of a Medical Cyclotron

    International Nuclear Information System (INIS)

    Dela Cruz, Joselito

    2015-01-01

    Khealth Corporation, in Partnership with the National Kidney and Transplant Institute, has established a medical cyclotron facility to accommodate the up-and-coming needs of tracers for PET/CT in different centers and hospitals all over the country. This facility houses a 16.5 MeV GE PET trace 880 particle accelerator that can produce 14 Ci (518 GBq) of Fluorine-18. Its structure has adopted global standard designs in meeting the safety during its use, radiopharmaceutical production and distribution. Compliances were remarkably fulfilled from the building construction, machine acquisition, commissioning, operations up to the quality control and assurance. Furthermore, various regulatory challenges during the current standardization of radiopharmaceutical utilization were encountered however time dedication and efforts were wielded until all have been successfully justified and acquired. (author)

  14. Relationship between sensory results and compliance scores in grated Parmigiano-Reggiano cheese

    Directory of Open Access Journals (Sweden)

    Mario Zannoni

    2015-12-01

    Full Text Available The regulations for Protected Designation of Origin require a certification body to verify compliance with the provisions of the product specification. The grated Parmigiano-Reggiano is evaluated with a scorecard containing 21 quantitative descriptors and 4 qualitative evaluations of compliance with the regulations. To better understand the relationship between sensory compliance and quantitative descriptors we have tested 24 samples of grated Parmigiano-Reggiano. Correlations and Partial Least Squares gave us a better understanding of compliance evaluation. The work allowed us to define the most important descriptors in relationship with compliance and showed that it is possible to predict compliance values using descriptor values.

  15. Compliance with pharmacological treatment in outpatients from a Brazilian cardiology referral center

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Chizzola

    Full Text Available To evaluate the degree of compliance with pharmacological therapy, and to identify predictors of non-compliance in outpatients from a cardiology referral center in São Paulo, Brazil, we studied 485 outpatients, 230 (47.4 percent males and 255 (52.6 percent females, through an interview guided by a questionnaire during medical consultation. The ages ranged between 17 and 86 (mean 54, standard deviation 15 years. Heart disease and socioeconomic factors (residence, means of transport, educational level and professional status were studied. In addition, we examined the drugs prescribed including: difficulties in taking them; the source of supply; and the patient's knowledge of the drugs. Assessment of compliance was based on the patients' response. The patients' answers were compared with the prescription and progress notes. Errors were recorded if the patient reported using one or more nonprescribed medicines. Compliance with therapy was recorded if the patient said the prescription was taken correctly without interruption and without error. The variables with significant differences in univariate analysis were further analyzed by multivariate log-linear regression analysis. Noncompliance occurred in 286 (59 percent of the patients, and was predicted by the reported difficulty in taking medication (P<0.001, and by the lack of knowledge of medication names (P<0.001.Thus, noncompliance with medical therapy was common. The main predictors of non-compliance were the reported difficulty in taking medication and inability to identify medicines' names.

  16. Architecture-based regulatory compliance argumentation

    DEFF Research Database (Denmark)

    Mihaylov, Boyan; Onea, Lucian; Hansen, Klaus Marius

    2016-01-01

    Standards and regulations are difficult to understand and map to software, which makes compliance with them challenging to argue for software products and development process. This is problematic since lack of compliance may lead to issues with security, safety, and even to economic sanctions....... An increasing number of applications (for example in healthcare) are expected to have to live up to regulatory requirements in the future, which will lead to more software development projects having to deal with such requirements. We present an approach that models regulations such that compliance arguments...... the approach on the migration of the telemedicine platform Net4Care to the cloud, where certain regulations (for example privacy) should be concerned. The approach has the potential to support simpler compliance argumentation with the eventual promise of safer and more secure applications....

  17. Preclinical medical students’ understandings of academic and medical professionalism: visual analysis of mind maps

    Science.gov (United States)

    Rees, Charlotte E

    2017-01-01

    Introduction Several studies have begun to explore medical students’ understandings of professionalism generally and medical professionalism specifically. Despite espoused relationships between academic (AP) and medical professionalism (MP), previous research has not yet investigated students’ conceptualisations of AP and MP and the relationships between the two. Objectives The current study, based on innovative visual analysis of mind maps, therefore aims to contribute to the developing literature on how professionalism is understood. Methods We performed a multilayered analysis of 98 mind maps from 262 first-year medical students, including analysing textual and graphical elements of AP, MP and the relationships between AP and MP. Results The most common textual attributes of AP were learning, lifestyle and personality, while attributes of MP were knowledge, ethics and patient-doctor relations. Images of books, academic caps and teachers were used most often to represent AP, while images of the stethoscope, doctor and red cross were used to symbolise MP. While AP-MP relations were sometimes indicated through co-occurring text, visual connections and higher-order visual metaphors, many students struggled to articulate the relationships between AP and MP. Conclusions While the mind maps’ textual attributes shared similarities with those found in previous research, suggesting the universality of some professionalism attributes, our study provides new insights into students’ conceptualisations of AP, MP and AP-MP relationships. We encourage medical educators to help students develop their understandings of AP, MP and AP-MP relationships, plus consider the feasibility and value of mind maps as a source of visual data for medical education research. PMID:28821520

  18. Patient compliance with drug therapy for postmenopausal osteoporosis

    International Nuclear Information System (INIS)

    Ahmad, A.; Khan, M.Y.

    2007-01-01

    To determine compliance and factors affecting compliance to antiresorptive drugs in osteoporosis, and to compare compliant and non compliant groups in a tertiary care setting. A total of 800 patients with postmenopausal osteoporosis were included in the study. The demographic and reproductive characteristics of all the patients were recorded. Type of antiresorptive drugs prescribed, degree of compliance, time and reasons for discontinuation were studied and analyzed. The mean age of the patients was 64 (+-9) years and their mean duration of follow-up 18 (+-5) months. The prevalence of risk factors for osteoporosis were evenly distributed among treatment groups; 73% patients had a co-morbidity besides osteoporosis while 27% were osteoporotic alone. One or more previous vertebral fractures due to osteoporosis was reported by 14.5% of patients, whereas 35.5% had at least one non-vertebral fracture in their medical history. Out of the total patients 21.5% discontinued the prescribed drug before attending the bone mass re-evaluations, more than half of these within first six months of starting the drugs. The medication that was most frequently discontinued within one year was calcium and vitamin-D (33.7%, p<0.01) while the least discontinued medication was Alendronate (5.9%, p < 0.01) which is taken once a week. In this study the most important determinant of compliance was the type of drug prescribed and its dose frequency, with a definite preference for Alendronate once a week. Treatment compliance was particularly poor for calcium and vitamin-D regimen, thereby emphasizing the need to find new ways of administering supplements, particularly for vitamin-D. (author)

  19. Understanding Medical Words: A Tutorial from the National Library of Medicine

    Science.gov (United States)

    ... page: https://medlineplus.gov/medicalwords.html Understanding Medical Words: A Tutorial from the National Library of Medicine ... enable JavaScript. This tutorial teaches you about medical words. You'll learn about how to put together ...

  20. Compliance in rheumatoid arthritis and the role of formal patient education

    NARCIS (Netherlands)

    Brus, H.L.M.; Brus, Herman; van de Laar, Mart A F J; Taal, Erik; Rasker, Johannes J.; Wiegman, O.

    1997-01-01

    Objective: This study was performed to determine the compliance with the basic treatments for rheumatoid arthritis (RA; medication, physical therapy, and ergonomic measures), to study psychological factors that influence compliance in light of the social learning theory, to learn whether patient

  1. TU-AB-204-03: Research Activities in Medical Physics

    International Nuclear Information System (INIS)

    Badano, A.

    2016-01-01

    The responsibilities of the Food and Drug Administration (FDA) have increased since the inception of the Food and Drugs Act in 1906. Medical devices first came under comprehensive regulation with the passage of the 1938 Food, Drug, and Cosmetic Act. In 1971 FDA also took on the responsibility for consumer protection against unnecessary exposure to radiation-emitting devices for home and occupational use. However it was not until 1976, under the Medical Device Regulation Act, that the FDA was responsible for the safety and effectiveness of medical devices. This session will be presented by the Division of Radiological Health (DRH) and the Division of Imaging, Diagnostics, and Software Reliability (DIDSR) from the Center for Devices and Radiological Health (CDRH) at the FDA. The symposium will discuss on how we protect and promote public health with a focus on medical physics applications organized into four areas: pre-market device review, post-market surveillance, device compliance, current regulatory research efforts and partnerships with other organizations. The pre-market session will summarize the pathways FDA uses to regulate the investigational use and commercialization of diagnostic imaging and radiation therapy medical devices in the US, highlighting resources available to assist investigators and manufacturers. The post-market session will explain the post-market surveillance and compliance activities FDA performs to monitor the safety and effectiveness of devices on the market. The third session will describe research efforts that support the regulatory mission of the Agency. An overview of our regulatory research portfolio to advance our understanding of medical physics and imaging technologies and approaches to their evaluation will be discussed. Lastly, mechanisms that FDA uses to seek public input and promote collaborations with professional, government, and international organizations, such as AAPM, International Electrotechnical Commission (IEC

  2. TU-AB-204-03: Research Activities in Medical Physics

    Energy Technology Data Exchange (ETDEWEB)

    Badano, A. [Food & Drug Administration (United States)

    2016-06-15

    The responsibilities of the Food and Drug Administration (FDA) have increased since the inception of the Food and Drugs Act in 1906. Medical devices first came under comprehensive regulation with the passage of the 1938 Food, Drug, and Cosmetic Act. In 1971 FDA also took on the responsibility for consumer protection against unnecessary exposure to radiation-emitting devices for home and occupational use. However it was not until 1976, under the Medical Device Regulation Act, that the FDA was responsible for the safety and effectiveness of medical devices. This session will be presented by the Division of Radiological Health (DRH) and the Division of Imaging, Diagnostics, and Software Reliability (DIDSR) from the Center for Devices and Radiological Health (CDRH) at the FDA. The symposium will discuss on how we protect and promote public health with a focus on medical physics applications organized into four areas: pre-market device review, post-market surveillance, device compliance, current regulatory research efforts and partnerships with other organizations. The pre-market session will summarize the pathways FDA uses to regulate the investigational use and commercialization of diagnostic imaging and radiation therapy medical devices in the US, highlighting resources available to assist investigators and manufacturers. The post-market session will explain the post-market surveillance and compliance activities FDA performs to monitor the safety and effectiveness of devices on the market. The third session will describe research efforts that support the regulatory mission of the Agency. An overview of our regulatory research portfolio to advance our understanding of medical physics and imaging technologies and approaches to their evaluation will be discussed. Lastly, mechanisms that FDA uses to seek public input and promote collaborations with professional, government, and international organizations, such as AAPM, International Electrotechnical Commission (IEC

  3. review of compliance to anti tuberculosis treatment and risk factors ...

    African Journals Online (AJOL)

    Background: The aim of this study is to assess anti TB treatment compliance and the factors predictive for poor adherence in Sub-Saharan Africa in the last 10 years. Methods: We searched Medline for articles written in English using the terms: "Patient Compliance"[Mesh] OR "Medication Adherence"[Mesh])) AND ...

  4. Compliance/adherence and care management in HIV disease.

    Science.gov (United States)

    Crespo-Fierro, M

    1997-01-01

    With the changing perspectives of the HIV epidemic and the introduction of protease inhibitors to treat human immunodeficiency virus (HIV) disease, the issue of compliance has gained considerable interest among health care providers. The idea that clients with HIV disease should succumb to a patriarchal system of medical care has been challenged by AIDS activists since the beginning of the epidemic. The concept that there is only one explanation for "noncompliance" is outdated. The reasons for noncompliance are multifaceted in nature and include psychosocial factors, complex medication and treatment regimens, ethnocultural concerns, and in many instances substance use. Therefore, the notion that there is one intervention to resolve noncompliance is at best archaic. Interventions to enhance compliance include supervised therapy, improving the nurse-client relationship, and patient education, all of which should be combined with ethnocultural interventions. Plans to enhance compliance must incorporate person-specific variables and should be tailored to individualized needs.

  5. Do medical students really understand plagiarism? - Case study.

    Science.gov (United States)

    Badea, Oana

    2017-01-01

    In the last decade, more and more medicine students are involved in research, either in the form of a research project within specialized courses or as a scientific article to be presented at student international conferences or published in prestigious medical journals. The present study included 250 2nd year medical students, currently studying within the University of Medicine and Pharmacy of Craiova, Romania. There were collected 239 responses, with a response rate of 95.6%. In our study, the results showed that foreign students within the University of Medicine and Pharmacy of Craiova did have some issues understanding plagiarism with fewer foreign students (34%) than Romanian students (66%) recognizing that simply changing words does not avoid plagiarism. In our opinion, there should be put more emphasis upon plagiarism implications and its aspects, as well, with a permanent order to try to prevent future attempts of plagiarizing among medical students as future researchers within the medical science field.

  6. The role of the psychiatrist in improving patient compliance.

    Science.gov (United States)

    Hotujac, Ljubomir

    2007-02-01

    Compliance, usually referring to how well the patient takes the medication as prescribed, is an important issue in clinical practice. However, many patients, especially those with a psychiatric illness, stop taking their medications despite physician advice to continue. This cessation can lead to a deterioration in the condition, a relapse, or a recurrence of the illness. In the literature, many different factors contributing to poor compliance have been described, but the doctor's role and responsibilities are hardly mentioned. These factors will be discussed here with special emphasis on what a doctor should do and what a doctor should avoid.

  7. Compliance and Caregiver Satisfaction in Alzheimer’s Disease: Results from the AXEPT Study

    Directory of Open Access Journals (Sweden)

    Roberto Bernabei

    2012-10-01

    Full Text Available Background/Aims: According to experimental data, a transdermal application is preferred by caregivers of Alzheimer’s disease (AD patients compared with oral medications. The AXEPT study compared compliance to treatment among community-dwelling patients with mild-to-moderate AD treated with transdermal application compared to oral medications and caregiver satisfaction in a real clinical setting. Methods: Data from 45 memory clinics in Italy were collected between September 8, 2010 and January 31, 2011. Compliance to treatment and caregiver satisfaction were measured using the Caregiver Medication Interview. Results: A total of 855 AD patients and their caregivers participated in the study. Nearly 80% of caregivers of patients on patch were not concerned about adherence to treatment compared with 64% of caregivers of patients on oral drugs. Among caregivers of patients on patch, 94% did not report any difficulties in remembering to administer treatment compared with 73% of caregivers of patients on oral medications. The highest level of compliance and satisfaction was reported by caregivers of patients on transdermal application. Conclusion: Caregivers of patients treated with a transdermal application appeared to be more satisfied and reported a higher level of compliance than caregivers of patients receiving anti-AD oral medications.

  8. Science to compliance: The WIPP success story

    International Nuclear Information System (INIS)

    Howarth, S.M.; Chu, M.S.; Shephard, L.E.

    1997-01-01

    The Waste Isolation Pilot Plant (WIPP) in southeast New Mexico has been studied as a transuranic waste repository for the past 23 years. During this time, an extensive site characterization, design, construction, and experimental program was completed to provide in-depth understanding of the dominant processes that are most likely to influence the containment of radionuclides for 10,000 years. The success of the program, however, is defined by the regulator in the context of compliance with performance criteria, rather than by the in-depth technical understanding typical of most scientific programs. The WIPP project was successful in making a transformation from science to compliance by refocusing and redirecting programmatic efforts toward the singular goal of meeting regulatory compliance requirements while accelerating the submittal of the Compliance Certification Application (CCA) by two months from the April 1994 Disposal Decision Plan (DDP) date of December 1996, and by reducing projected characterization costs by more than 40%. This experience is unparalleled within the radioactive waste management community and has contributed to numerous lessons learned from which the entire community can benefit

  9. Issues with prescribed medications in Aboriginal communities: Aboriginal health workers' perspectives.

    Science.gov (United States)

    Hamrosi, Kim; Taylor, Susan J; Aslani, Parisa

    2006-01-01

    local Aboriginal communities. The Aboriginal health workers reported a general lack of access to medications and frequent inappropriate use of medications due to limited understanding, literacy and information all of which lead to non-compliance with instructions. Medication sharing was common in their communities. They reported that many Aboriginal people were uncomfortable seeking medicines advice, and the consumer medicine information provided was often difficult to understand, culturally inappropriate and unlikely to be utilised. Strategies suggested to improve pharmacist services and access to the services were a more 'Aboriginal friendly' environment, relationship development between pharmacists and Aboriginal health workers, cultural awareness programs for pharmacists and their staff, provision of disease state management services and medicine education programs by pharmacists for Aboriginal health workers. Medication misunderstandings and non-compliance within the Aboriginal community frequently occur. Suggestions to improve access, understanding and compliance, along with the education and training of Aboriginal health workers may provide tools for self-determination. Pharmacists may be well positioned to provide Aboriginal health workers with medicines information and patient education skills, and encourage the effective use of medicines within the Aboriginal community.

  10. Understanding Medical Research

    Science.gov (United States)

    ... you hear about the results of a new medical research study. Sometimes the results of one study ... when reading or listening to reports of new medical findings. Some questions that can help you evaluate ...

  11. Burnout syndrome: understanding of medical teaching professionals

    OpenAIRE

    Jaqueline Brito Vidal Batista; Thaíza Ferreira Costa; Jocerlânia Maria Dias de Morais; Eveline de Oliveira Barros; Patrícia Serpa de Souza Batista; Márcia Adriana Dias Meirelles Moreira; Jessyka Cibelly Minervina da Costa Silva; Débora Rodrigues Alves de Lima; Ana Hévila Marinho Bezerra; Irany Carvalho da Silva

    2017-01-01

    This study aimed to investigate the understanding of medical teaching professionals about Burnout Syndrome. This is a qualitative, exploratory study, consisting of ten teaching physicians, who work at the hospital of a higher education institution. The data were collected from May to June 2013, through a form with questions pertinent to the proposed research objective, after approval by the Research Ethics Committee (Protocol No. 84022), and analyzed qualitatively, through the content analysi...

  12. Pediatric Nurses' Perceptions of Medication Safety and Medication Error: A Mixed Methods Study.

    Science.gov (United States)

    Alomari, Albara; Wilson, Val; Solman, Annette; Bajorek, Beata; Tinsley, Patricia

    2017-05-30

    This study aims to outline the current workplace culture of medication practice in a pediatric medical ward. The objective is to explore the perceptions of nurses in a pediatric clinical setting as to why medication administration errors occur. As nurses have a central role in the medication process, it is essential to explore nurses' perceptions of the factors influencing the medication process. Without this understanding, it is difficult to develop effective prevention strategies aimed at reducing medication administration errors. Previous studies were limited to exploring a single and specific aspect of medication safety. The methods used in these studies were limited to survey designs which may lead to incomplete or inadequate information being provided. This study is phase 1 on an action research project. Data collection included a direct observation of nurses during medication preparation and administration, audit based on the medication policy, and guidelines and focus groups with nursing staff. A thematic analysis was undertaken by each author independently to analyze the observation notes and focus group transcripts. Simple descriptive statistics were used to analyze the audit data. The study was conducted in a specialized pediatric medical ward. Four key themes were identified from the combined quantitative and qualitative data: (1) understanding medication errors, (2) the busy-ness of nurses, (3) the physical environment, and (4) compliance with medication policy and practice guidelines. Workload, frequent interruptions to process, poor physical environment design, lack of preparation space, and impractical medication policies are identified as barriers to safe medication practice. Overcoming these barriers requires organizations to review medication process policies and engage nurses more in medication safety research and in designing clinical guidelines for their own practice.

  13. Exploring medical identity theft.

    Science.gov (United States)

    Mancilla, Desla; Moczygemba, Jackie

    2009-09-16

    The crime of medical identity theft is a growing concern in healthcare institutions. A mixed-method study design including a two-stage electronic survey, telephone survey follow-up, and on-site observations was used to evaluate current practices in admitting and registration departments to reduce the occurrence of medical identity theft. Survey participants were chief compliance officers in acute healthcare organizations and members of the Health Care Compliance Association. Study results indicate variance in whether or how patient identity is confirmed in healthcare settings. The findings of this study suggest that information systems need to be designed for more efficient identity management. Admitting and registration staff must be trained, and compliance with medical identity theft policies and procedures must be monitored. Finally, biometric identity management solutions should be considered for stronger patient identification verification.

  14. Hand hygiene compliance rates: Fact or fiction?

    Science.gov (United States)

    McLaws, Mary-Louise; Kwok, Yen Lee Angela

    2018-05-16

    The mandatory national hand hygiene program requires Australian public hospitals to use direct human auditing to establish compliance rates. To establish the magnitude of the Hawthorne effect, we compared direct human audit rates with concurrent automated surveillance rates. A large tertiary Australian teaching hospital previously trialed automated surveillance while simultaneously performing mandatory human audits for 20 minutes daily on a medical and a surgical ward. Subtracting automated surveillance rates from human audit rates provided differences in percentage points (PPs) for each of the 3 quarterly reporting periods for 2014 and 2015. Direct human audit rates for the medical ward were inflated by an average of 55 PPs in 2014 and 64 PPs in 2015, 2.8-3.1 times higher than automated surveillance rates. The rates for the surgical ward were inflated by an average of 32 PPs in 2014 and 31 PPs in 2015, 1.6 times higher than automated surveillance rates. Over the 6 mandatory reporting quarters, human audits collected an average of 255 opportunities, whereas automation collected 578 times more data, averaging 147,308 opportunities per quarter. The magnitude of the Hawthorne effect on direct human auditing was not trivial and produced highly inflated compliance rates. Mandatory compliance necessitates accuracy that only automated surveillance can achieve, whereas daily hand hygiene ambassadors or reminder technology could harness clinicians' ability to hyperrespond to produce habitual compliance. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  15. DEVELOPMENT OF THE QUESTIONNAIRE ON COMPLIANCE TO MEDICAL NUTRITION THERAPY FOR TYPE 2 DIABETIC PATIENTS AND ASSESSMENT OF ITS POTENTIAL USE

    Directory of Open Access Journals (Sweden)

    E. G. Starostina

    2016-01-01

    Full Text Available Background: А  specific questionnaire is necessary to perform quantitative assessment of compliance to medical nutrition therapy in patients with type 2 diabetes mellitus (DM.Aim: Тo develop a questionnaire to assess how type 2 diabetic patients adhere with the principles of medical nutrition therapy and to identify factors associated with good dietary compliance.Materials and methods: We proposed a questionnaire "Dietary adherence test" (DAT and validated it in 300 inand out-patients with type 2 DM. DAT was validated against the diabetes-related behavior score, diabetes-related knowledge score, and HbA1c level; the internal consistency coefficient (Cronbach's alfa was also calculated.Results: Cronbach's alfa for primary raw and standardized data were 0.7444 and 0.7413, respectively, thus meeting the required range of 0.7–0.8. The score on DAT item 1 (the title item and total score (the sum of scores of item 2 to 10 correlated with the diabetes-related behavior score (r=0.21, р=0.0006 and r=0.34, р<0.0001, respectively. Patients with poor dietary compliance (average DAT score≤2 had a significantly lower score on the subscale "Nutrition" of the diabetes knowledge test, than those with good dietary compliance (average DAT score≥2 (44.9±15.6 vs 60.2±16.2, р<0.0001. Patients who perceived their diet as the most burdensome element of life with diabetes, had lower total DAT score (24.1±4.6 than those who did not see their diet as a problem (25.9±5.1, р=0.001. There was a  significant difference in average DAT score between patients on insulin therapy and patients on oral treatment (2.8±0.6 vs 2.9±0.6, respectively, р=0.019. Patients with poor and good dietary adherence, according to DAT, differed in their duration of diabetes, social status and diabetes-related behavior score. There was a  weak correlation between the DAT score and duration of diabetes (r=0.16, р=0.009, and weak inverse correlation between the DAT score and

  16. Drug Brand Response and Its Impact on Compliance and Efficacy in Depression Patients.

    Science.gov (United States)

    Li, Mingming; Cai, Jian; Zhang, Ping; Fei, Chunhua; Xu, Feng

    2016-01-01

    Introduction: Patient's response to drug brand is a comprehensive physiological and psychological effect which might impact the compliance and efficacy of drugs. Whether the therapeutic outcome altered on patients with brand response after they experience drug switch is not clear. Methods: 459 outpatients with mild-to-moderate depression were divided into the imported (joint venture) drug group and the domestic drug group according to their current drug application. Two groups of patients were assessed by drug brand preference questionnaire and medication compliance questionnaire. Patients with brand preference in imported (joint venture) drugs group received rational use of limited medical resource and pharmacoeconomics education, and then switched with domestic drug for 8 weeks. Safety and efficacy were evaluated both before and after the drug switch. Results: Overall, there were 27% of patients in imported drug group and 35% of patients in domestic drug group have brand response, respectively. About 2/3 patients in both groups showed low or no brand response. The compliance was similar in both groups with no significant difference (6.04 ± 2.08 vs. 4.74 ± 2.13, respectively, P > 0.05). The efficacy of imported drug group was significantly better than of the domestic drug group. Correlation analysis showed that in imported (joint venture) drugs group, medication compliance was closely related with brand response, but negatively correlated with age and duration. In domestic drugs group, medication compliance was independent of brand response, but closely related with education, age, and duration. After drug switch with domestic drug on patients with brand response, patients continued to maintain good antidepressant effect, and no severe adverse reaction occurred. Conclusion: The results suggested that domestic drugs switch might be feasible for patients using imported drugs with brand response, while providing patients with rational use of drug education and

  17. Prediction of compliance with MRI procedures among children of ages 3 years to 12 years

    International Nuclear Information System (INIS)

    Cahoon, Glenn D.; Davison, Tanya E.

    2014-01-01

    A number of children are unable to comply with an MRI procedure and require general anesthetic. However, we lack information about which factors are associated with MRI compliance in young children. To determine the strongest predictors of MRI compliance, focusing on variables that can be easily rated by patients' parents. A sample of 205 children ages 3-11 years (mean age 6.6 years) who were at risk of non-compliance were recruited from a children's hospital. Their parents completed a behavior assessment scale for children as well as a questionnaire that assessed their expectations of compliance and perception of their child's typical medical compliance. The children subsequently completed a mock MRI with an educational play therapist and a clinical MRI, with the quality of the scan scored by the MRI technologist. Overall, 88.3% of children complied with the clinical scan and achieved diagnostic images, with age unrelated to compliance in this well-prepared patient group. The strongest predictors of MRI compliance were parental expectations and ratings of how well the child typically copes with medical procedures. Non-compliance was related to child attention problems and to poor adaptability among children. A total of 64 preschool-age children (91.4%) and 110 school-age children (95.7%) were correctly classified as compliant or non-compliant based on these predictor variables. A child's temperament, medical experiences and parental expectations provide important information in predicting which children successfully comply with an MRI procedure and which require general anesthesia. Further study is needed to explore the utility of these variables in predicting compliance at sites that do not have access to an MRI simulator. (orig.)

  18. Satisfactions, Self-Efficacy, and Compliance in Mandatory Technology Settings

    Science.gov (United States)

    Devgan, Vipan

    2012-01-01

    Many organizations recognize employees as great assets in the efforts to reduce risk related to information security. Employee's compliance with information security rules and regulations of organization is the key to strengthening information security. It is crucial for organizations to understand factors affecting technology compliance to…

  19. Hand hygiene compliance in patients under contact precautions and in the general hospital population.

    Science.gov (United States)

    Almaguer-Leyva, Martín; Mendoza-Flores, Lidia; Medina-Torres, Ana Gabriela; Salinas-Caballero, Ana Gabriela; Vidaña-Amaro, Jose Antonio; Garza-Gonzalez, Elvira; Camacho-Ortiz, Adrián

    2013-11-01

    Hand hygiene (HH) is the single most important intervention for preventing hospital-acquired infections. Contact precautions are a series of actions that infection control units take to reduce the transmission of nosocomial pathogens. We conducted an observational study of HH compliance. Observations were stratified as opportunities in patients under contact precautions and in the general hospital population. Trained infection control personnel performed all direct evaluations. A total of 3,270 opportunities were recorded. HH compliance was statistically higher in patients on contact precautions than in the overall population (70.3% vs 60.4%; P = .0001). Critical care areas had higher HH compliance when patients were isolated by contact precautions. Medical wards were statistically lower in HH when patients were under contact precautions. Respiratory technicians had the highest HH compliance in both overall performance and in patients under contact precautions. Medical students had a lower HH compliance in both evaluations (P Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  20. Dietary supplement good manufacturing practices: preparing for compliance

    National Research Council Canada - National Science Library

    Mead, William J

    2012-01-01

    .... Based on broad experience with GMP compliance techniques worked out over the years in the food, drug, and medical device industries, it is a must-have guide for all DS companies, especially the many...

  1. Dietary compliance in Iranian children and adolescents with celiac disease

    Directory of Open Access Journals (Sweden)

    Taghdir M

    2016-08-01

    Full Text Available Maryam Taghdir,1 Naser Honar,2 Seyed Mohammad Mazloomi,3 Mojtaba Sepandi,4 Mahkameh Ashourpour,1 Musa Salehi5 1Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; 2Department of Pediatric Gastroenterology and Hepatology, Shiraz University of Medical Sciences, Shiraz, Iran; 3Nutrition Research Center, Department of Food Hygiene and Quality Control, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; 4Department of Epidemiology and Biostatistics, Baqyiatallah University of Medical Sciences, Tehran, Iran; 5Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Introduction: Celiac disease (CD is caused due to intake of gluten, a protein component in wheat, barley, and rye. The only treatment currently available for CD is strict lifetime adherence to a gluten-free diet (GFD which is a diet that excludes wheat, barley, and rye. There is limited information on barriers to following a GFD. The present study aimed to investigate the compliance with a GFD, barriers to compliance, and the impact of compliance on the quality of life (QOL in Iranian children and adolescents suffering from CD.Methods: In this cross-sectional study, a total of 65 known cases of CD (both males and females, diagnosed in Namazi Hospital, a large referral center in south of Iran, selected by census were studied in 2014. Dietary compliance was assessed using a questionnaire. A disease-specific QOL questionnaire for children with CD (the celiac disease DUX [CDDUX] was used. Comparisons between categorical variables were performed using chi-square test.Results: Sixty-five patients, 38 females (58.5% and 27 (41.5% males, were surveyed. Mean (± standard deviation [SD] age of the respondents was 11.3 (±3.8 years. Dietary compliance was reported by

  2. Ophthalmologists' awareness of informed consent and their compliance to its requirements.

    Science.gov (United States)

    Ehteshami, Asghar; Isfahani, Sakineh Saghaeiannejad; Saeedbakhsh, Saeed; Isfahani, Mahtab Kasaei

    2013-01-01

    Healthcare providers' awareness of laws governing medical documents and patients' health-related information is essential in securing the patients' rights. Given the existing legal problems in documentation of medical record of Consent and Acquittal, we decided to perform an investigation examining the levels of ophthalmologists' awareness of legal requirements for medical record of consent and acquittal and how they complied with such requirements at Feiz Teaching Hospital, Isfahan in the year 2011. This research is an applied, descriptive-analytic one. The research population for awareness measurement includes attending ophthalmologists at Feiz Hospital. Filled-in consent record forms recorded in medical document were used to examine the levels of compliance with legal requirements governing medical record of consent and acquittal. Sampling among the attending ophthalmologists was performed using consensus which included 14 ophthalmologists. The files were samples using the statistical formula, resulting in a sample of 303 files. Data collection tools included a questionnaire and a check list. The questionnaire's reliability was estimated through Cronbach's alpha calculation (0.8); and the check list was completed through a survey among professors of Health Information Technology Management department. In a first step, investigators handed a questionnaire containing 12 items to the ophthalmologists in order to assess their levels of awareness from legal Aspects of medical Informed consent and acquittal, and received the completed questionnaire after answering their possible queries on the issue. In the next step the researchers went to the hospital and evaluated the levels of compliance with legal aspects of medical informed consent and acquittal within the files using a check list and by direct observation. Analytic statistics and SPSS software were used to analyze the data; and Pearson test was applied to evaluate the assumed relationship. The findings were

  3. Experience with a pharmacy technician medication history program.

    Science.gov (United States)

    Cooper, Julie B; Lilliston, Michelle; Brooks, DeAnne; Swords, Bruce

    2014-09-15

    The implementation and outcomes of a pharmacy technician medication history program are described. An interprofessional medication reconciliation team, led by a clinical pharmacist and a clinical nurse specialist, was charged with implementing a new electronic medication reconciliation system to improve compliance with medication reconciliation at discharge and capture compliance-linked reimbursement. The team recommended that the pharmacy department be allocated new pharmacy technician full-time-equivalent positions to assume ownership of the medication history process. Concurrent with the implementation of this program, a medication history standard was developed to define rules for documentation of what a patient reports he or she is actually taking. The standard requires a structured interview with the patient or caregiver and validation with outside sources as indicated to determine which medications to document in the medication history. The standard is based on four medication administration category rules: scheduled, as-needed, short-term, and discontinued medications. The medication history standard forms the core of the medication history technician training and accountability program. Pharmacy technicians are supervised by pharmacists, using a defined accountability plan based on a set of medical staff approved rules for what medications comprise a best possible medication history. Medication history accuracy and completeness rates have been consistently over 90% and rates of provider compliance with medication reconciliation rose from under 20% to 100% since program implementation. A defined medication history based on a medication history standard served as an effective foundation for a pharmacy technician medication history program, which helped improve provider compliance with discharge medication reconciliation. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  4. A study of reasons of non-compliance of psychiatric treatment and patients' attitudes towards illness and treatment in Qatar.

    Science.gov (United States)

    Bener, Abdulbari; Dafeeah, Elnour E; Salem, Mohamad O

    2013-04-01

    The aim of this study was to examine the extent of psychiatric patients' compliance and non-compliance with treatment and examine the factors that affect compliance. Patients were recruited who were between 16 and 60 years of age and who were hospitalized with a psychiatric disorder and treated in the outpatient clinics of the psychiatry department. A total of 689 patients were approached and 564 patients agreed to participate in the study, a response rate of 81.8%. Participants were asked to complete a questionnaire that asked about socio-demographic characteristics (e.g., age, gender, nationality, level of education, occupation, marital status, and life style habits); medication(s) prescribed and the participant's response; the degree of social supervision (rated subjectively by the patient as "poor," "good," or "very good"); data also were obtained from clinical records. Data analyses explored significant associations between compliance and non-compliance and a group of relevant variables. Of the 564 patients studied, 328 (58.2%) were compliant with treatment and 236 (41.8%) were non-compliant. There was no significant difference between compliance and non-compliance in terms of gender (p = 0.471). Patients between 21-30 years of age were significantly more compliant with drug treatment than not. Non-compliance was more common among patients diagnosed with schizophrenia (28.4%), followed by depression (14.4%), and bipolar affective disorder (12.7%) (p = 0.001). Only 25% of compliant patients and 26.3% of non-compliant patients used non-psychotropic medication. Social supervision (40%) was very poor in non-compliant patients whereas 49.4% of compliant patients had very good family support. Notable reasons for non-compliance were irregular attendance to clinic (55.5%), ignorance about side effects of medication (61%), free medicine (45.8%), and a lack of education about medication (58.1%). This study revealed that non-compliance rates among psychiatry patients

  5. The elderly on dialysis: some considerations in compliance.

    Science.gov (United States)

    McKevitt, P M; Jones, J F; Lane, D A; Marion, R R

    1990-10-01

    Compliance with scheduled treatments, dietary and fluid restrictions, and multiple medications is an important component in the care and well-being of end-stage renal disease (ESRD) patients. Given the rigorus and complex demands of dialysis, it is important to examine the issue of compliance, focusing on a large and ever-increasing segment of our patient population, the elderly. The ESRD literature reflects efforts to define and measure levels of compliance, identify factors that influence and predict compliance, and develop intervention strategies to improve adherence to treatment regimens. While limited attention has been focused specifically on the elderly, there are studies suggesting that age may be a factor associated with improved adherence and that social support may be a significant contributor to compliance in this patient group. In an effort to examine the current status and needs of the dialysis elderly, research is in progress at Chromalloy American Kidney Center, Washington University, which replicates a study of 5 years ago. Eighty-four patients age 60 and over, on dialysis for a minimum of 6 months, were identified. Sociodemographic, treatment, compliance, and functional capacity data were collected; additional mental and psychological testing was completed on patients willing and able to participate. Preliminary data suggest the current elderly population is larger and significantly older than that of 5 years ago. Other sociodemographic data indicate the population is increasingly female, black, and more socioeconomically disadvantaged. In regard to compliance, the vast majority of elderly demonstrate good compliance as measured by serum potassium, fair to good compliance with phosphorus, and fair to poor compliance with fluid restrictions.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Prediction of compliance with MRI procedures among children of ages 3 years to 12 years

    Energy Technology Data Exchange (ETDEWEB)

    Cahoon, Glenn D. [The Royal Children' s Hospital Melbourne, Medical Imaging Department, Parkville (Australia); Davison, Tanya E. [Monash University, Melbourne (Australia)

    2014-10-15

    A number of children are unable to comply with an MRI procedure and require general anesthetic. However, we lack information about which factors are associated with MRI compliance in young children. To determine the strongest predictors of MRI compliance, focusing on variables that can be easily rated by patients' parents. A sample of 205 children ages 3-11 years (mean age 6.6 years) who were at risk of non-compliance were recruited from a children's hospital. Their parents completed a behavior assessment scale for children as well as a questionnaire that assessed their expectations of compliance and perception of their child's typical medical compliance. The children subsequently completed a mock MRI with an educational play therapist and a clinical MRI, with the quality of the scan scored by the MRI technologist. Overall, 88.3% of children complied with the clinical scan and achieved diagnostic images, with age unrelated to compliance in this well-prepared patient group. The strongest predictors of MRI compliance were parental expectations and ratings of how well the child typically copes with medical procedures. Non-compliance was related to child attention problems and to poor adaptability among children. A total of 64 preschool-age children (91.4%) and 110 school-age children (95.7%) were correctly classified as compliant or non-compliant based on these predictor variables. A child's temperament, medical experiences and parental expectations provide important information in predicting which children successfully comply with an MRI procedure and which require general anesthesia. Further study is needed to explore the utility of these variables in predicting compliance at sites that do not have access to an MRI simulator. (orig.)

  7. The effective compliance of spatially evolving planar wing-cracks

    Science.gov (United States)

    Ayyagari, R. S.; Daphalapurkar, N. P.; Ramesh, K. T.

    2018-02-01

    We present an analytic closed form solution for anisotropic change in compliance due to the spatial evolution of planar wing-cracks in a material subjected to largely compressive loading. A fully three-dimensional anisotropic compliance tensor is defined and evaluated considering the wing-crack mechanism, using a mixed-approach based on kinematic and energetic arguments to derive the coefficients in incremental compliance. Material, kinematic and kinetic parametric influences on the increments in compliance are studied in order to understand their physical implications on material failure. Model verification is carried out through comparisons to experimental uniaxial compression results to showcase the predictive capabilities of the current study.

  8. Effect of a system-oriented intervention on compliance problems in schizophrenia

    DEFF Research Database (Denmark)

    Skarsholm, Hanne; Støvring, Henrik; Nielsen, Bent

    2014-01-01

    Background. Numerous studies have been conducted with a view to developing strategies for improvement of medical compliance in patients with schizophrenia. All of the studies conducted so far have had an individual approach to compliance based on the assumption that noncompliance is determined...... individually due to inappropriate behavior in the patient. We conducted a pragmatic controlled trial with a system-oriented approach, to provide a new perspective on compliance and test the efficacy of a multifactorial intervention at the system level in a routine clinical setting, an approach that has...... not previously been used for the improvement of compliance. Methods. 30 patients were allocated to the system-oriented therapy and 40 patients were allocated to the reference intervention, which consisted of individually based compliance therapy. The follow-up period was six months. Primary endpoint...

  9. New approach for cognitive analysis and understanding of medical patterns and visualizations

    Science.gov (United States)

    Ogiela, Marek R.; Tadeusiewicz, Ryszard

    2003-11-01

    This paper presents new opportunities for applying linguistic description of the picture merit content and AI methods to undertake tasks of the automatic understanding of images semantics in intelligent medical information systems. A successful obtaining of the crucial semantic content of the medical image may contribute considerably to the creation of new intelligent multimedia cognitive medical systems. Thanks to the new idea of cognitive resonance between stream of the data extracted from the image using linguistic methods and expectations taken from the representaion of the medical knowledge, it is possible to understand the merit content of the image even if teh form of the image is very different from any known pattern. This article proves that structural techniques of artificial intelligence may be applied in the case of tasks related to automatic classification and machine perception based on semantic pattern content in order to determine the semantic meaning of the patterns. In the paper are described some examples presenting ways of applying such techniques in the creation of cognitive vision systems for selected classes of medical images. On the base of scientific research described in the paper we try to build some new systems for collecting, storing, retrieving and intelligent interpreting selected medical images especially obtained in radiological and MRI examinations.

  10. Patient empowerment by increasing the understanding of medical language for lay users.

    Science.gov (United States)

    Topac, V; Stoicu-Tivadar, V

    2013-01-01

    Patient empowerment is important in order to increase the quality of medical care and the life quality of the patients. An important obstacle for empowering patients is the language barrier the lay patient encounter when accessing medical information. To design and develop a service that will help increase the understanding of medical language for lay persons. The service identifies and explains medical terminology from a given text by annotating the terms in the original text with the definition. It is based on an original terminology interpretation engine that uses a fuzzy matching dictionary. The service was implemented in two projects: a) into the server of a tele-care system (TELEASIS) with the purpose of adapting medical text assigned by medical personnel for the assisted patients. b) Into a dedicated web site that can adapt the medical language from raw text or from existing web pages. The output of the service was evaluated by a group of persons, and the results indicate that such a system can increase the understanding of medical texts. Several design decisions were driven from the evaluation, and are being considered for future development. Other tests measuring accuracy and time performance for the fuzzy terminology recognition have been performed. Test results revealed good performance for accuracy and excellent results regarding time performance. The current version of the service increases the accessibility of medical language by explaining terminology with a good accuracy, while allowing the user to easily identify errors, in order to reduce the risk of incorrect terminology recognition.

  11. Alternative Compliance: Guidelines for Preparing and Submitting a Waiver Request Application and Other Documentation Requirements

    Energy Technology Data Exchange (ETDEWEB)

    2013-03-01

    This document is designed to assist covered fleets interested in taking advantage of more flexible compliance options and to facilitate the transition from Standard Compliance to Alternative Compliance. It is designed to help fleets better understand the Alternative Compliance option and successfully complete the waiver application process.

  12. Alternative Compliance: Guidelines for Preparing and Submitting a Waiver Request Application and Other Documentation Requirements

    Energy Technology Data Exchange (ETDEWEB)

    Sears, Ted [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2014-06-01

    This document is designed to assist covered fleets interested in taking advantage of more flexible compliance options and to facilitate the transition from Standard Compliance to Alternative Compliance. It is designed to help fleets better understand the Alternative Compliance option and successfully complete the waiver application process.

  13. Assessment of parental understanding of paediatric medical prescriptions

    Directory of Open Access Journals (Sweden)

    Sadiqua Anjum, Nasir Mohiuddin M, Narayan Reddy U, Narsing Rao J, Sana Afreen, Mir S Adil, Javeedullah M

    2014-07-01

    Full Text Available Introduction: Medical prescriptions are bound to be misinterpreted by patients and pharmacists if not properly conveyed. Pediatric prescriptions differ from adult prescriptions having wide variation in doses and formulations. There is a need to evaluate the lacunae in the parental understanding of pediatric prescriptions. Aims and objective: To evaluate the parental understanding of pediatric prescription and to evaluate the adequacy of communication with the physician and pharmacist regarding the same. Material and methods: 550 parents were enrolled and their literacy level was noted. They were subjected to modify MUSE questionnaire. Physician’s prescription was analyzed in terms of ease of understanding by parents. These parents were followed up till the pharmacies and the pharmacist understanding of prescription was analyzed and their communication with parents regarding drug usage was noted. Finally, ease of usage of drugs by parents was noted. Results: MUSE scale was modified to suit pediatric prescription understanding by parents and also additional questions were asked to include complete parental understanding of doctor’s prescription. Majority of parents failed to completely understand the written prescription. Though around 80% of pharmacist could understand the prescription, their communication with parents was poor resulting in difficulty for parents to even enquire about medicines from them. Parental overall understanding of prescription increased with their literacy levels. Conclusion: Not all prescriptions are completely understood by parents as well as a pharmacist. This can lead to misuse of drugs. Efforts to explain the drug usage are not adequate enough from the doctor or the pharmacist. While communicating literacy levels of parents is not being considered which may further worsen the understanding ability

  14. Medical Practitioners Act 2007: the increased medical record burden.

    LENUS (Irish Health Repository)

    Byrne, D

    2010-03-01

    New medical record keeping obligations are implemented by the Medical Practitioners Act (2007), effective July 2009. This audit, comprising review of 347 medical entries in 257 charts on one day, investigated compliance with the Act together with the general standard of medical record keeping. The Medical Council requirement was absent all but 3 (0.9%) of entries; there was no unique identifier or signature in 28 (8%) and 135 (39%) of entries respectively. The case for change is discussed.

  15. 40 CFR 60.39e - Compliance times.

    Science.gov (United States)

    2010-07-01

    ... PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Hospital/Medical... site preparation for installation of the air pollution control device(s); (7) Date for initiation of installation of the air pollution control device(s); (8) Date for initial startup of the air pollution control...

  16. A compliance testing program for diagnostic X-ray equipment

    International Nuclear Information System (INIS)

    Hutchinson, D.E.; Cobb, B.J.; Jacob, C.S.

    1999-01-01

    Compliance testing is nominally that part of a quality assurance program dealing with those aspects of X-ray equipment performance that are subject to radiation control legislation. Quality assurance programs for medical X-ray equipment should be an integral part of the quality culture in health care. However while major hospitals and individual medical centers may implement such programs with some diligence, much X-ray equipment can remain unappraised unless there is a comprehensive regulatory inspection program or some form of compulsion on the equipment owner to implement a testing program. Since the late 1950s all X-ray equipment in the State of Western Australia has been inspected by authorized officers acting on behalf of the Radiological Council, the regulatory authority responsible for administration of the State's Radiation Safety Act. However, economic constraints, coupled with increasing X-ray equipment numbers and a geographically large State have significantly affected the inspection rate. Data available from inspections demonstrate that regular compliance and performance checks are essential in order to ensure proper performance and to minimize unnecessary patient and operator dose. To ensure that diagnostic X-ray equipment complies with accepted standards and performance criteria, the regulatory authority introduced a compulsory compliance testing program for all medical, dental and chiropractic diagnostic X-ray equipment effective from 1 January 1997

  17. Noninfectious uveitis: strategies to optimize treatment compliance and adherence

    Directory of Open Access Journals (Sweden)

    Dolz-Marco R

    2015-08-01

    Full Text Available Rosa Dolz-Marco,1 Roberto Gallego-Pinazo,1 Manuel Díaz-Llopis,2 Emmett T Cunningham Jr,3–6 J Fernando Arévalo7,8 1Unit of Macula, Department of Ophthalmology, University and Polytechnic Hospital La Fe, 2Faculty of Medicine, University of Valencia, Spain; 3Department of Ophthalmology, California Pacific Medical Center, San Francisco, 4Department of Ophthalmology, Stanford University School of Medicine, Stanford, 5The Francis I Proctor Foundation, University of California San Francisco Medical Center, 6West Coast Retina Medical Group, San Francisco, CA, USA; 7Vitreoretina Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 8Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Noninfectious uveitis includes a heterogenous group of sight-threatening ocular and systemic disorders. Significant progress has been made in the treatment of noninfectious uveitis in recent years, particularly with regard to the effective use of corticosteroids and non-corticosteroid immunosuppressive drugs, including biologic agents. All of these therapeutic approaches are limited, however, by any given patient’s ability to comply with and adhere to their prescribed treatment. In fact, compliance and adherence are among the most important patient-related determinants of treatment success. We discuss strategies to optimize compliance and adherence. Keywords: noninfectious uveitis, intraocular inflammation, immunosuppressive treatment, adherence, compliance, therapeutic failure

  18. Medical Students' Understanding of Directed Questioning by Their Clinical Preceptors.

    Science.gov (United States)

    Lo, Lawrence; Regehr, Glenn

    2017-01-01

    Phenomenon: Throughout clerkship, preceptors ask medical students questions for both assessment and teaching purposes. However, the cognitive and strategic aspects of students' approaches to managing this situation have not been explored. Without an understanding of how students approach the question and answer activity, medical educators are unable to appreciate how effectively this activity fulfills their purposes of assessment or determine the activity's associated educational effects. A convenience sample of nine 4th-year medical students participated in semistructured one-on-one interviews exploring their approaches to managing situations in which they have been challenged with questions from preceptors to which they do not know the answer. Through an iterative and recursive analytic reading of the interview transcripts, data were coded and organized to identify themes relevant to the students' considerations in answering such questions. Students articulated deliberate strategies for managing the directed questioning activity, which at times focused on the optimization of their learning but always included considerations of image management. Managing image involved projecting not only being knowledgeable but also being teachable. The students indicated that their considerations in selecting an appropriate strategy in a given situation involved their perceptions of their preceptors' intentions and preferences as well as several contextual factors. Insights: The medical students we interviewed were quite sophisticated in their understanding of the social nuances of the directed questioning process and described a variety of contextually invoked strategies to manage the situation and maintain a positive image.

  19. Understanding the drivers on medical workloads: an analysis of spectators at the Australian Football League.

    Science.gov (United States)

    Zeitz, Kathryn; Haghighi, Pari Delir; Burstein, Frada; Williams, Jeffrey

    2013-06-01

    The present study was designed to further understand the psychosocial drivers of crowds impacting on the demand for healthcare. This involved analysing different spectator crowds for medical usage at mass gatherings; more specifically, did different football team spectators (of the Australian Football League) generate different medical usage rates. In total, 317 games were analysed from 10 venues over 2 years. Data were analysed by the ANOVA and Pearson correlation tests. RESULTS; Spectators who supported different football teams generated statistically significant differences in patient presentation rates (PPR) (F15, 618=1.998, P=0.014). The present study confirmed previous findings that there is a positive correlation between the crowd size and PPR at mass gatherings but found a negative correlation between density and PPR (r = -0.206, n=317, Pemergency medical care. In measuring demand for emergency medical services there is a need to develop a more sophisticated understanding of a variety of drivers in addition to traditional metrics such as temperature, crowd size and other physical elements. In this study we saw that spectators who supported different football teams generated statistically significant differences in PPR. What is known about this topic? Understanding the drivers of emergency medical care is most important in the mass gathering setting. There has been minimal analysis of psychological 'crowd' variables. What does this paper add? This study explores the psychosocial impact of supporting a different team on the PPR of spectators at Australian Football League matches. The value of collecting and analysing these types of data sets is to support more balanced planning, better decision support and knowledge management, and more effective emergency medical demand management. What are the implications for practitioners? This information further expands the body of evidence being created to understand the drivers of emergency medical demand and usage

  20. Alternative Compliance: Guidelines for Preparing and Submitting a Waiver Request Application and Other Documentation Requirements (Book)

    Energy Technology Data Exchange (ETDEWEB)

    2010-11-01

    This document is designed to assist covered fleets interested in taking advantage of more flexible compliance options and to facilitate the transition from Standard Compliance to Alternative Compliance. It is designed to help fleets better understand the Alternative Compliance option and successfully complete the waiver application process.

  1. Alternative Compliance: Guidelines for Preparing and Submitting a Waiver Request Application and Other Documentation Requirements (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2014-06-01

    This document is designed to assist covered fleets interested in taking advantage of more flexible compliance options and to facilitate the transition from Standard Compliance to Alternative Compliance. It is designed to help fleets better understand the Alternative Compliance option and successfully complete the waiver application process.

  2. Compliance with occlusion therapy for childhood amblyopia.

    Science.gov (United States)

    Wallace, Michael P; Stewart, Catherine E; Moseley, Merrick J; Stephens, David A; Fielder, Alistair R

    2013-09-17

    Explore compliance with occlusion treatment of amblyopia in the Monitored and Randomized Occlusion Treatment of Amblyopia Studies (MOTAS and ROTAS), using objective monitoring. Both studies had a three-phase protocol: initial assessment, refractive adaptation, and occlusion. In the occlusion phase, participants were instructed to dose for 6 hours/day (MOTAS) or randomized to 6 or 12 hour/day (ROTAS). Dose was monitored continuously using an occlusion dose monitor (ODM). One hundred and fifty-two patients (71 male, 81 female; 122 Caucasian, 30 non-Caucasian) of mean ± SD age 68 ± 18 months participated. Amblyopia was defined as an interocular acuity difference of at least 0.1 logMAR and was associated with anisometropia in 50, strabismus in 44, and both (mixed) in 58. Median duration of occlusion was 99 days (interquartile range 72 days). Mean compliance was 44%, mean proportion of days with no patch worn was 42%. Compliance was lower (39%) on weekends compared with weekdays (46%, P = 0.04), as was the likelihood of dosing at all (52% vs. 60%, P = 0.028). Compliance was lower when attendance was less frequent (P amblyopia type, and severity were not associated with compliance. Mixture modeling suggested three subpopulations of patch day doses: less than 30 minutes; doses that achieve 30% to 80% compliance; and doses that achieve around 100% compliance. This study shows that compliance with patching treatment averages less than 50% and is influenced by several factors. A greater understanding of these influences should improve treatment outcome. (ClinicalTrials.gov number, NCT00274664).

  3. Patient compliance with a health care provider referral for an occupational therapy lymphedema consult.

    Science.gov (United States)

    Dominick, Sally A; Natarajan, Loki; Pierce, John P; Madanat, Hala; Madlensky, Lisa

    2014-07-01

    Limited information exists on breast cancer patients' compliance to attend outpatient appointments with an occupational therapy (OT) lymphedema specialist. The objectives of this study were (1) to examine patient compliance with a health care provider referral for an OT lymphedema consult and (2) to identify potential barriers to compliance. A retrospective chart review of female breast cancer patients at the UC San Diego Health System was conducted. Electronic medical records were queried for breast cancer patients, who received a health care provider referral for an OT lymphedema consult between June 1, 2010 and December 31, 2011. Descriptive statistics and Fisher's exact chi-square tests were used to examine how specific participant characteristics were associated with attending an OT appointment. A total of 210 female patients received an OT referral from a health care provider related to their breast cancer diagnosis. Forty-three (20.5%) patients did not attend an OT appointment. Non-attenders were more likely to have had fewer lymph nodes removed (Pcancer patients attended recommended OT lymphedema consults, a substantial number of women might benefit from further education about OT for lymphedema prevention following breast cancer treatment. Further research to understand barriers to attendance is recommended, particularly among women with only sentinel nodes removed.

  4. 28 CFR 73.4 - Partial compliance not deemed compliance.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Partial compliance not deemed compliance. 73.4 Section 73.4 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NOTIFICATIONS TO THE ATTORNEY GENERAL BY AGENTS OF FOREIGN GOVERNMENTS § 73.4 Partial compliance not deemed compliance. The fact...

  5. Tax Compliance Inventory: TAX-I Voluntary tax compliance, enforced tax compliance, tax avoidance, and tax evasion

    Science.gov (United States)

    Kirchler, Erich; Wahl, Ingrid

    2010-01-01

    Surveys on tax compliance and non-compliance often rely on ad hoc formulated items which lack standardization and empirical validation. We present an inventory to assess tax compliance and distinguish between different forms of compliance and non-compliance: voluntary versus enforced compliance, tax avoidance, and tax evasion. First, items to measure voluntary and enforced compliance, avoidance, and evasion were drawn up (collected from past research and newly developed), and tested empirically with the aim of producing four validated scales with a clear factorial structure. Second, findings from the first analyses were replicated and extended to validation on the basis of motivational postures. A standardized inventory is provided which can be used in surveys in order to collect data which are comparable across research focusing on self-reports. The inventory can be used in either of two ways: either in its entirety, or by applying the single scales independently, allowing an economical and fast assessment of different facets of tax compliance. PMID:20502612

  6. Tax Compliance Inventory: TAX-I Voluntary tax compliance, enforced tax compliance, tax avoidance, and tax evasion.

    Science.gov (United States)

    Kirchler, Erich; Wahl, Ingrid

    2010-06-01

    Surveys on tax compliance and non-compliance often rely on ad hoc formulated items which lack standardization and empirical validation. We present an inventory to assess tax compliance and distinguish between different forms of compliance and non-compliance: voluntary versus enforced compliance, tax avoidance, and tax evasion. First, items to measure voluntary and enforced compliance, avoidance, and evasion were drawn up (collected from past research and newly developed), and tested empirically with the aim of producing four validated scales with a clear factorial structure. Second, findings from the first analyses were replicated and extended to validation on the basis of motivational postures. A standardized inventory is provided which can be used in surveys in order to collect data which are comparable across research focusing on self-reports. The inventory can be used in either of two ways: either in its entirety, or by applying the single scales independently, allowing an economical and fast assessment of different facets of tax compliance.

  7. Design evolution enhances patient compliance for low-intensity pulsed ultrasound device usage

    Directory of Open Access Journals (Sweden)

    Pounder NM

    2016-11-01

    Full Text Available Neill M Pounder, John T Jones, Kevin J Tanis Bioventus LLC, Durham, NC, USA Abstract: Poor patient compliance or nonadherence with prescribed treatments can have a significant unfavorable impact on medical costs and clinical outcomes. In the current study, voice-of-the-customer research was conducted to aid in the development of a next-generation low-intensity pulsed ultrasound (LIPUS bone healing product. An opportunity to improve patient compliance reporting was identified, resulting in the incorporation into the next-generation device of a visual calendar that provides direct feedback to the patient, indicating days for which they successfully completed treatment. Further ­investigation was done on whether inclusion of the visual calendar improved patient adherence to the prescribed therapy (20 minutes of daily treatment over a 6-month period. Thus, 12,984 data files were analyzed from patients prescribed either the earlier- or the next-generation LIPUS device. Over the 6-month period, overall patient compliance was 83.8% with the next-generation LIPUS device, compared with 74.2% for the previous version (p<0.0001. Incorporation of the calendar feature resulted in compliance never decreasing below 76% over the analysis period, whereas compliance with the earlier-generation product fell to 51%. A literature review on the LIPUS device shows a correlation between clinical effectiveness and compliance rates more than 70%. Incorporation of stakeholder feedback throughout the design and innovation process of a next-generation LIPUS device resulted in a measurable improvement in patient adherence, which may help to optimize clinical outcomes. Keywords: LIPUS, ultrasound, compliance, patient adherence, medical device design

  8. Understanding Compliance in Patriarchal Religions: Mormon Women and the Latter Day Saints Church as a Case Study

    Directory of Open Access Journals (Sweden)

    Reid Leamaster

    2018-04-01

    Full Text Available Defining compliance as acquiescence in situations of inequality, this article explores patterns of compliance to gender traditionalism from the analysis of interviews with Mormon women. Analysis reveals that Mormon women face unique, context-specific mechanisms for stifling resistance to gender traditionalism. Additionally, many of the Mormon women interviewed who do not comply with traditional gender expectations regarding motherhood still accept and defend gender traditionalism. We explain this pattern with a concept that we call ideological compensation, which means that women in gender traditional religions defend gender traditionalism even if they do not live it as a way to compensate for their non-compliance. Finally, we find that some of the women frame their compliance to Mormon gender traditionalism as a statement of resistance against the broader society. We describe this phenomenon with a concept known as subcultural resistance. Overall, this study sheds light on how Mormon women interpret traditional gender expectations and the mechanisms that are put in place to stifle resistance.

  9. A preliminary study to understand tacit knowledge and visual routines of medical experts through gaze tracking.

    Science.gov (United States)

    Anderson, Blake; Shyu, Chi-Ren

    2010-11-13

    Many decisions made by medical experts are based on scans from advanced imaging technologies. Interpreting a medical image is a trained, systematic procedure and an excellent target for identifying potential visual routines through image informatics. These visual routines derived from experts contain many clues about visual knowledge and its representation. This study uses an inexpensive webcam-based gaze tracking method to collect data from multiple technologists' survey of medical and non-medical images. Through computational analysis of the results, we expect to provide insight into the behaviors and properties related to medical visual routines. Discovering the visual processes associated with medical images will help us recognize and understand the tacit knowledge gained from extensive experience with medical imagery. These expert routines could potentially be used to reduce medical error, train new experts, and provide an understanding of the human visual system in medicine.

  10. Aortic compliance in patients with aortic regurgitation. Evaluation with magnetic resonance imaging

    International Nuclear Information System (INIS)

    Murai, Sachiko; Hamada, Seiki; Ueguchi, Takashi

    2005-01-01

    The purpose of this study was to assess by means of cine magnetic resonance imaging (MRI) aortic compliance before and after aortic valve replacement (AVR with SJM (St. Jude Medical, St paul, MN) valve) in patients with aortic regurgitation (AR). Two groups (healthy controls and patients with severe isolated AR) of 10 subjects each were included in this study. Cine MRI was performed at three locations of the aorta, and aortic compliance was calculated by dividing the maximum change in the aortic area by pulse pressure. Cine MRI is useful to assess abnormalities of aortic compliance in patients with AR. Compared with the control group, aortic compliance in the AR group was significantly less in the ascending aorta (p<0.05), decreasing in order of aortic location. After AVR, aortic compliance improved for all locations. Cine MRI enables assessment of aortic biophysical properties such as a compliance for evaluating the progression of AR and the efficacy of treatment. (author)

  11. 76 FR 28308 - Compliance Policy Guide: Surgeons' Gloves and Patient Examination Gloves; Defects-Criteria for...

    Science.gov (United States)

    2011-05-17

    .... FDA-2011-D-0258] Compliance Policy Guide: Surgeons' Gloves and Patient Examination Gloves; Defects... Compliance Policy Guide Sec. 335.700, Surgeons' Gloves and Patient Examination Gloves; Defects--Criteria for... FDA staff on the submission of seizure recommendations for medical gloves that exceed the defect...

  12. Electronic compliance monitoring of topical treatment after ophthalmic surgery.

    Science.gov (United States)

    Hermann, Manuel Marcel; Ustündag, Can; Diestelhorst, Michael

    2010-08-01

    The success of many medical treatments is built on compliance. Electronic monitoring is the most accurate tool to quantify compliance by measuring adherence. In order to assess the efficiency of a recently introduced miniature monitoring device for eye drop application, we evaluated adherence in ophthalmic patients undergoing post-operative short-term topical treatment. This pilot study enrolled 30 outpatients (mean age 61.8 +/- 18.5 years) after cataract (n = 24) and glaucoma filtration surgery (n = 6) applying fixed-combination eye drops containing prednisolone and gentamicin five times daily for 2 weeks. Patients received eye drops in conventional bottles each equipped with a miniature monitoring device recording events of application. Two patients failed to bring back the monitoring device; therefore data collected from only 28 patients could be examined. Data showed highly variable results with a mean dose compliance of 50.2%. Dose compliance was below 25% in approximately one out of five patients. Four cataract patients, but no glaucoma patient, discontinued therapy prematurely. The observed mean dosage interval was calculated for each patient and ranged 4.6-19.7 h. Thirty percent of analysed dosage intervals exceeded 12.0 h. Different patterns of compliance behaviour-like early non-persistence, drug holiday and low treatment frequency could be identified and illustrated using electronic data. Age or gender did not significantly influence compliance rates. Our pilot study demonstrates successful electronic compliance monitoring using a technology capable of continuous data recording over weeks of treatment. The low compliance rate for a relevant part of the patients demonstrates the necessity to study and improve compliance in ophthalmology. In future, new application methods and electronic application devices may improve treatment response in eye care.

  13. ADAPTIF CONSERVATION (ACM MODEL IN INCREASING FAMILY SUPPORT AND COMPLIANCE TREATMENT IN PATIENT WITH PULONARY TUBERCULOSIS IN SURABAYA CITY REGION

    Directory of Open Access Journals (Sweden)

    Siti Nur Kholifah

    2017-04-01

    Full Text Available Introduction: Tuberculosis (TB in Indonesia is still health problem and the prevalence rate is high. Discontinuing medication and lack of family support are the causalities. Numbers of strategies to overcome are seemingly not succeeded. Roles and responsibilities of family nursing are crucial to improve participation, motivation of individual, family and community in prevention, including pulmonary tuberculosis. Unfortunately, models of pulmonary tuberculosis currently unavailable. The combination of adaptation and conservation in complementarily improving family support and compliance in medication is introduced in this study. Method: This research intended to analyze Adaptive Conservation Model (ACM in extending family support and treatment compliance. Modeling steps including model analysis, expert validation, field trial, implementation and recommending the output model. Research subject involves 15 families who implement family Assistance and supervision in Medication (ASM and other 15 families with ACM. Result: The study revealed ACM is better than ASM on the case of family support and medication compliances. It supports the role of environment as influential factor on individual health belief, values and decision making. Therefore, it is advised to apply ACM in enhancing family support and compliance of pulmonary TB patients. Discussion: Social and family supports to ACM group obtained by developing interaction through communication. Family interaction necessary to improve family support to pulmonary tuberculosis patients. And social support plays as motivator to maintain compliance on medication

  14. 15 CFR Notes Applicable to State... - Notes applicable to State of Understanding related to Medical Equipment:

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Notes applicable to State of Understanding related to Medical Equipment: applicable Notes applicable to State of Understanding related to Medical Equipment: Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY,...

  15. Improving venous thromboembolic disease prophylaxis in medical inpatients: a role for education and audit.

    LENUS (Irish Health Repository)

    Kent, B D

    2012-02-01

    BACKGROUND: Venous thromboembolic disease (VTED) prophylaxis is a key strategy in reducing preventable deaths in medical inpatients. We assessed compliance with internationally published guidelines for VTED prophylaxis in at-risk medical patients before and 1 month after an educational intervention to enhance compliance with such guidelines. RESULTS: One hundred and fifty patients were assessed on each occasion. Pre-intervention, VTED prophylaxis was prescribed in only 48% of at-risk cases. Compliance was best among patients under stroke services and worst for those under acute medical teams. Patients within specialist units were more likely to be prescribed prophylaxis than those in general wards (75 vs. 53%; p = 0.0019). Post-intervention, overall compliance improved to 63% (p = 0.041 for comparison). There was a significant improvement among general medical teams (48 vs. 75%; p = 0.001), and in general wards (52 vs. 74%; p = 0.003). CONCLUSIONS: Thromboprophylaxis is under-prescribed in medical inpatients, but compliance with international guidelines can be significantly enhanced with targeted educational intervention.

  16. Decision making about pre-medication to children.

    Science.gov (United States)

    Proczkowska-Björklund, M; Runeson, I; Gustafsson, P A; Svedin, C G

    2008-11-01

    Inviting the child to participate in medical decisions regarding common medical procedures might influence the child's behaviour during the procedures. We wanted to study nurse decision-making communication regarding pre-medication before ear, nose and throat (ENT) surgery. In total, 102 children (3-6 years) signed for ENT surgery were video-filmed during the pre-medication process. The nurse decision-making communication was identified, transcribed and grouped in six main categories dependent on the level of participation (self-determination, compromise, negotiation, questioning, information, lack of communication). Associations between child factors (age, gender, verbal communication and non-verbal communication) and different nurse decision-making communication were studied. Associations between the decision-making communication and verbal hesitation and/or the child's compliance in taking pre-medication were also studied. Totally, information was the most frequently used category of decision making communication followed by negotiation and questioning. To the children showing signs of shyness, the nurse used more negotiation, questions and self-determination communication and less information. The nurse used more compromise, negotiation and gave less information to children with less compliance. No specific type of nurse decision-making communication was associated with verbal hesitation. The most important predictors for verbal hesitation were none or hesitant eye contact with nurse (OR = 4.5) and placement nearby or in parent's lap (OR = 4.7). Predictors for less compliance in taking pre-medication were verbal hesitation from the child (OR = 22.7) and children who did not give any verbal answer to nurse initial questions (OR = 5.5). Decision-making communication could not predict the child's compliance during pre-medication. Although negotiation, questioning and self-determination communication were associated with more unwillingness to take pre-medication

  17. Helping medical students to acquire a deeper understanding of truth-telling.

    Science.gov (United States)

    Hurst, Samia A; Baroffio, Anne; Ummel, Marinette; Burn, Carine Layat

    2015-01-01

    Truth-telling is an important component of respect for patients' self-determination, but in the context of breaking bad news, it is also a distressing and difficult task. We investigated the long-term influence of a simulated patient-based teaching intervention, integrating learning objectives in communication skills and ethics into students' attitudes and concerns regarding truth-telling. We followed two cohorts of medical students from the preclinical third year to their clinical rotations (fifth year). Open-ended responses were analysed to explore medical students' reported difficulties in breaking bad news. This intervention was implemented during the last preclinical year of a problem-based medical curriculum, in collaboration between the doctor-patient communication and ethics programs. Over time, concerns such as empathy and truthfulness shifted from a personal to a relational focus. Whereas 'truthfulness' was a concern for the content of the message, 'truth-telling' included concerns on how information was communicated and how realistically it was received. Truth-telling required empathy, adaptation to the patient, and appropriate management of emotions, both for the patient's welfare and for a realistic understanding of the situation. Our study confirms that an intervention confronting students with a realistic situation succeeds in making them more aware of the real issues of truth-telling. Medical students deepened their reflection over time, acquiring a deeper understanding of the relational dimension of values such as truth-telling, and honing their view of empathy.

  18. Helping medical students to acquire a deeper understanding of truth-telling

    Directory of Open Access Journals (Sweden)

    Samia A. Hurst

    2015-11-01

    Full Text Available Problem: Truth-telling is an important component of respect for patients’ self-determination, but in the context of breaking bad news, it is also a distressing and difficult task. Intervention: We investigated the long-term influence of a simulated patient-based teaching intervention, integrating learning objectives in communication skills and ethics into students’ attitudes and concerns regarding truth-telling. We followed two cohorts of medical students from the preclinical third year to their clinical rotations (fifth year. Open-ended responses were analysed to explore medical students’ reported difficulties in breaking bad news. Context: This intervention was implemented during the last preclinical year of a problem-based medical curriculum, in collaboration between the doctor–patient communication and ethics programs. Outcome: Over time, concerns such as empathy and truthfulness shifted from a personal to a relational focus. Whereas ‘truthfulness’ was a concern for the content of the message, ‘truth-telling’ included concerns on how information was communicated and how realistically it was received. Truth-telling required empathy, adaptation to the patient, and appropriate management of emotions, both for the patient's welfare and for a realistic understanding of the situation. Lessons learned: Our study confirms that an intervention confronting students with a realistic situation succeeds in making them more aware of the real issues of truth-telling. Medical students deepened their reflection over time, acquiring a deeper understanding of the relational dimension of values such as truth-telling, and honing their view of empathy.

  19. A logistic regression analysis of factors related to the treatment compliance of infertile patients with polycystic ovary syndrome.

    Science.gov (United States)

    Li, Saijiao; He, Aiyan; Yang, Jing; Yin, TaiLang; Xu, Wangming

    2011-01-01

    To investigate factors that can affect compliance with treatment of polycystic ovary syndrome (PCOS) in infertile patients and to provide a basis for clinical treatment, specialist consultation and health education. Patient compliance was assessed via a questionnaire based on the Morisky-Green test and the treatment principles of PCOS. Then interviews were conducted with 99 infertile patients diagnosed with PCOS at Renmin Hospital of Wuhan University in China, from March to September 2009. Finally, these data were analyzed using logistic regression analysis. Logistic regression analysis revealed that a total of 23 (25.6%) of the participants showed good compliance. Factors that significantly (p < 0.05) affected compliance with treatment were the patient's body mass index, convenience of medical treatment and concerns about adverse drug reactions. Patients who are obese, experience inconvenient medical treatment or are concerned about adverse drug reactions are more likely to exhibit noncompliance. Treatment education and intervention aimed at these patients should be strengthened in the clinic to improve treatment compliance. Further research is needed to better elucidate the compliance behavior of patients with PCOS.

  20. The impact of an electronic monitoring and reminder device on patient compliance with antihypertensive therapy

    DEFF Research Database (Denmark)

    Christensen, Arne; Christrup, Lona Louring; Fabricius, Paul Erik

    2010-01-01

    . In the first half of the study, patients using the device reported 91% compliance versus 85% in the control group. This difference diminished after crossover (88 versus 86%). BP was not affected. Electronic monitoring data on compliance revealed taking, dosing and timing compliance between 45 and 52% in study...... to be effective in improving patient compliance to some extent, but the combined effect has not been documented. OBJECTIVE: To assess the impact of an electronic reminder and monitoring device on patient compliance and BP control. METHODS: All patients received medical treatment with telmisartan once daily...... and were randomized to either electronic compliance monitoring with a reminder and monitoring device or standard therapy for 6 months. Both groups were crossed over after 6 months. Intervention effectiveness was assessed using self-reported compliance and BP. RESULTS: Data from 398 patients were analysed...

  1. A Retrospective Longitudinal Database Study of Persistence and Compliance with Treatment of Osteoporosis in Hungary.

    Science.gov (United States)

    Lakatos, Péter; Takács, István; Marton, István; Tóth, Emese; Zoltan, Cina; Lang, Zsolt; Psachoulia, Emi; Intorcia, Michele

    2016-03-01

    This study assessed persistence and compliance with anti-osteoporosis therapies, and associations between compliance and clinical outcomes (fracture, fracture-related hospitalization and death), in Hungarian women with postmenopausal osteoporosis. The study used the Hungarian National Health Insurance Fund Administration database and included women with PMO aged at least 50 years, for whom a prescription for anti-osteoporosis medication had been filled between 1 January 2004 and 31 December 2013 (index event). Persistence (prescription refilled within 8 weeks of the end of the previous supply) was evaluated over 2 years; good compliance (medication possession ratio ≥ 80 %) was evaluated at 1 year. Associations between compliance and clinical outcomes (data collected for up to 6 years) were assessed with adjustment for baseline covariates. A total of 296,300 women met the inclusion criteria (524,798 index events). Persistence and compliance were higher for less frequent and parenteral therapies (1- and 2-year persistence: half-yearly [parenteral] vs. daily/weekly/monthly [oral and parenteral], 81 and 38 % vs. 21-34 and 10-18 %, respectively; parenteral vs. oral, 75 and 36 % vs. 32 and 16 %; good compliance: half-yearly vs. daily/weekly/monthly, 70 vs. 24-39 %; parenteral vs. oral 78 vs. 36 %). Good compliance significantly reduced the risks of fracture, fracture-related hospitalization and death (relative risk vs. non-compliance [95 % confidence interval]: 0.77 [0.70-0.84], 0.72 [0.62-0.85] and 0.57 [0.51-0.64], respectively; P < 0.01). Improving compliance through long-interval parenteral therapies may result in clinical benefits for patients.

  2. Compliance with periodic surveillance for Von-Hippel-Lindau disease.

    Science.gov (United States)

    Lammens, Chantal R M; Aaronson, Neil K; Hes, Frederik J; Links, Thera P; Zonnenberg, Bernard A; Lenders, Jacques W M; Majoor-Krakauer, Danielle; Van Os, Theo A M; Gomez-Garcia, Encarna B; de Herder, Wouter; van der Luijt, Rob B; van den Ouweland, Ans M W; Van Hest, Liselot P; Verhoef, Senno; Bleiker, Eveline M A

    2011-06-01

    To assess compliance with a periodic surveillance regimen for Von Hippel-Lindau disease. In this nationwide study, Von Hippel-Lindau disease mutation carriers and those at 50% risk were invited to complete a questionnaire assessing (compliance with) advice given for periodic surveillance. Medical record data on compliance with recommended radiologic surveillance examinations were also collected. Of the 84 (77%) participants, 78 indicated having received advice to undergo periodic surveillance. Of these, 71 reported being fully compliant with that advice. In 64% of the cases, this advice was only partially consistent with published guidelines. Based on medical record data, between one quarter and one third of individuals did not undergo surveillance as recommended in the guidelines for central nervous system lesions and one half for visceral lesions. Screening delay for central nervous system lesions was significantly higher in one hospital and in those cases where "the advice given" deviated from the guidelines. The majority of those with or at risk of Von Hippel-Lindau disease reported having received and being fully compliant with screening advice. However, in many cases, the advice given was only partially consistent with published guidelines, and screening delays were observed. Efforts should be undertaken to stimulate guideline-based surveillance advice and to minimize screening delay.

  3. Improving compliance in remote healthcare systems through smartphone battery optimization.

    Science.gov (United States)

    Alshurafa, Nabil; Eastwood, Jo-Ann; Nyamathi, Suneil; Liu, Jason J; Xu, Wenyao; Ghasemzadeh, Hassan; Pourhomayoun, Mohammad; Sarrafzadeh, Majid

    2015-01-01

    Remote health monitoring (RHM) has emerged as a solution to help reduce the cost burden of unhealthy lifestyles and aging populations. Enhancing compliance to prescribed medical regimens is an essential challenge to many systems, even those using smartphone technology. In this paper, we provide a technique to improve smartphone battery consumption and examine the effects of smartphone battery lifetime on compliance, in an attempt to enhance users' adherence to remote monitoring systems. We deploy WANDA-CVD, an RHM system for patients at risk of cardiovascular disease (CVD), using a wearable smartphone for detection of physical activity. We tested the battery optimization technique in an in-lab pilot study and validated its effects on compliance in the Women's Heart Health Study. The battery optimization technique enhanced the battery lifetime by 192% on average, resulting in a 53% increase in compliance in the study. A system like WANDA-CVD can help increase smartphone battery lifetime for RHM systems monitoring physical activity.

  4. Awareness and compliance to anti-smoking law in South Bengaluru, India

    Directory of Open Access Journals (Sweden)

    Pradeep S. Banandur

    2017-09-01

    This is the first representative survey of awareness and compliance of COTPA in Bengaluru City. Low compliance, coupled with the lack of appropriate awareness among PRCs and AOs about COTPA, demands a comprehensive strategy to enhance awareness. Comprehensive efforts towards making all stakeholders understand the health impacts of smoking, and strict enforcement, might facilitate effective implementation of COTPA.

  5. Compliance with therapy in patients with chronic hepatitis C: associations with psychiatric symptoms, interpersonal problems, and mode of acquisition.

    Science.gov (United States)

    Kraus, M R; Schäfer, A; Csef, H; Faller, H; Mörk, H; Scheurlen, M

    2001-10-01

    Tolerance of interferon-a therapy for hepatitis C is often poor and medication is expensive. Compliance with diagnostic procedures and, even more important, with medical treatment is obviously critical to minimize the rate of dropouts and to maximize cost efficiency. Moreover, a good concordance with scheduled follow-ups is important for early recognition and treatment of interferon-associated side effects. Therefore, we investigated psychiatric symptoms, interpersonal problems, different modes of acquisition, and sociodemographic factors in HCV-infected patients as possible predictor variables of good versus poor compliance. In a longitudinal study, 74 patients with chronic hepatitis C (CHC) who fulfilled the criteria for treatment with interferon (IFN)-alpha-2b with or without ribavirin were investigated prospectively to identify those at risk for poor compliance during IFN medication. To assess predictive factors, we used both IIP-C (Inventory of Interpersonal Problems) and SCL-90-R (Symptom Check List 90 Items Revised) as psychometric instruments. Sociodemographic and somatic variables as well as compliance during IFN therapy were also evaluated. Poor compliance before or during medication was demonstrated by 23% (N = 17) of HCV patients. Sociodemographic factors and mode of acquisition, particularly former intravenous drug (IVD) abuse were not significantly linked with compliance. Logistic regression analysis demonstrated that the subgroup of patients with compliance problems was best identified by both pretherapeutic psychiatric symptoms and interpersonal problems. Predictive value was best and significant for anger-hostility (P = 0.009), intrusive (P = 0.014), depression (P = 0.015), and phobic anxiety (P = 0.049). Adopting this statistical prediction model, sensitivity was 47.1%, but specificity reached 98.3%. In total, 86.5% of cases were classified correctly. In situations of unclear indication for IFN therapy, psychological variables assessment of before

  6. Corporate compliance: framework and implementation.

    Science.gov (United States)

    Fowler, N

    1999-01-01

    The federal government has created numerous programs to combat fraud and abuse. The government now encourages healthcare facilities to have a corporate compliance program (CCP), a plan that reduces the chances that the facility will violate laws or regulations. A CCP is an organization-wide program comprised of a code of conduct and written policies, internal monitoring and auditing standards, employee training, feedback mechanisms and other features, all designed to prevent and detect violations of governmental laws, regulations and policies. It is a system or method ensuring that employees understand and will comply with laws that apply to what they do every day. Seven factors, based on federal sentencing guidelines, provide the framework for developing a CCP. First, a facility must establish rules that are reasonably capable of reducing criminal conduct. Second, high-level personnel must oversee the compliance effort. Third, a facility must use due care in delegating authority in the compliance initiative. Fourth, standards must be communicated effectively to employees, and fifth, a facility must take reasonable steps to achieve compliance. Sixth, standards must be enforced consistently across the organization and last, standards must be modified or changed for reported concerns, to ensure they are not repeated. PROMINA Health System, Inc. in Atlanta, Ga., designed a program to meet federal guidelines. It started with a self-assessment to define its areas or risk. Next, it created the internal structure and assigned organizational responsibility for running the CCP. PROMINA then developed standards of business and professional conduct, established vehicles of communication and trained employees on the standards. Finally, it continues to develop evidence of the program's effectiveness by monitoring and documenting its compliance activities.

  7. TREATMENT COMPLIANCE AMONG PATIENTS WITH CHRONIC PANCREATITIS IN THE MOSCOW REGION

    Directory of Open Access Journals (Sweden)

    S. V. Beljakova

    2014-01-01

    Full Text Available Background: In the past decade, incidence of chronic pancreatitis among different age groups has been growing globally and in Russia. Chronic pancreatitis is a progressive disease characterized by development of complications and decrease of exocrine function of pancreas. Treatment should be initiated early, before the complications occur; therapy should account for international experience and established Russian guidelines. Continuous usage of high-dose enzyme preparations preferably in modern dosage forms (microgranules, minimicrospheres or microtablets is one of the key principles in the management of chronic pancreatitis. Patient’s cooperative behavior and good compliance is crucial for achieving treatment targets. Aim: To assess treatment compliance among patients with chronic pancreatitis in the Moscow Region and to identify sources of information on the disease used by the patients. Materials and methods: One hundred patients with chronic pancreatitis in Moscow Region were questionnaired anonymously on their adherence to the medical recommendations for diet, alcohol consumption and medications, particularly enzyme preparations. Patients’ sources of information on the disease were also determined. Results: Poor compliance results were shown: only 28% of patients were fully adherent to medical recommendations; other patients took their medications irregularly, changed drug doses or preparations choosing less expensive and effective drugs. The majority of patients (89% were aware of the main treatment principles, though, 53% didn’t adhere to them. Patients used varied sources of information on the disease including special literature and the web; nevertheless, the information could be incorrectly understood. Only some patients received disease-related information from their physician, and many of the patients described physician-derived information as insufficient. As a result, treatment was often inadequate. Conclusion:  Improved

  8. Perceptions of personal health risks by medical and non-medical workers in a university medical center: a survey study

    Directory of Open Access Journals (Sweden)

    Nap Raoul E

    2010-11-01

    Full Text Available Abstract Background Health care workers (HCWs are faced with many work-related choices which may depend on how they perceive risk, such as whether or not to comply with safety regulations. Little research has investigated risk perception in medical workers in comparison with non-medical workers and the extent to which risk perception differs in these groups. The current study thus investigates risk perception of medical and non-medical workers to inform and complement future research on safety compliance. The study has implications for the design of intervention programmes to increase the level of compliance of HCWs. Methods A survey study was conducted in which questionnaires were distributed to 6380 HCWs. The questionnaire asked for ratings of risk perception for cold, annual influenza, pandemic influenza, cancer, heart attack and food poisoning. Of 2495 returned questionnaires (response rate: 39%, 61.40% were from medical workers (24.1% of these were from physicians, 39.7% from nurses and 36.2% from paramedics and 38.60% were from non-medical workers. Results Medical workers gave lower risk perception ratings than did non-medical workers for cancer, but not for other health risks. Within the medical workers, physicians rated the risk of getting a cold as higher, but of having a heart attack as lower than did nurses and paramedics; physicians also rated their risk of getting cancer as lower than did nurses. Perceived risk was higher as a function of age for pandemic influenza, cancer and heart attack, but lower for cold and annual influenza. HCWs who lived with a partner and children rated the risk of getting a cold or annual influenza higher than those who lived alone or with a partner only. Full-time HCWs gave lower ratings for annual influenza than did part-time HCWs. Conclusions Different base levels of risk perception between medical and non-medical workers need to be taken into account for successful implementation of safety regulations

  9. Tax Compliance Models: From Economic to Behavioral Approaches

    Directory of Open Access Journals (Sweden)

    Larissa Margareta BĂTRÂNCEA

    2012-06-01

    Full Text Available The paper reviews the models of tax compliance with an emphasis on economic and behavioral perspectives. Although the standard tax evasion model of Allingham and Sandmo and other similar economic models capture some important aspects of tax compliance (i.e., taxpayers’ response to increases in tax rate, audit probability, penalty rate they do not suffice the need for an accurate prediction of taxpayers’ behavior. The reason is that they do not offer a comprehensive perspective on the sociological and psychological factors which shape compliance (i.e., attitudes, beliefs, norms, perceptions, motivations. Therefore, the researchers have considered examining taxpayers’ inner motivations, beliefs, perceptions, attitudes in order to accurately predict taxpayers’ behavior. As a response to their quest, behavioral models of tax compliance have emerged. Among the sociological and psychological factors which shape tax compliance, the ‘slippery slope’ framework singles out trust in authorities and the perception of the power of authorities. The aim of the paper is to contribute to the understanding of the reasons for which there is a need for a tax compliance model which incorporates both economic and behavioral features and why governments and tax authorities should consider these models when designing fiscal policies.

  10. Psychological causes of non-compliance with electronically monitored occlusion therapy for amblyopia.

    Science.gov (United States)

    Loudon, S E; Passchier, J; Chaker, L; de Vos, S; Fronius, M; Harrad, R A; Looman, C W N; Simonsz, B; Simonsz, H J

    2009-11-01

    To analyse psychological causes for low compliance with occlusion therapy for amblyopia. In a randomised trial, the effect of an educational programme on electronically measured compliance had been assessed. 149 families who participated in this trial completed a questionnaire based on the Protection Motivation Theory after 8 months of treatment. Families with compliance less than 20% of prescribed occlusion hours were interviewed to better understand their cause for non-compliance. Poor compliance was most strongly associated with a high degree of distress (p<0.001), followed by low perception of vulnerability (p = 0.014), increased stigma (p = 0.017) and logistical problems with treatment (p = 0.044). Of 44 families with electronically measured compliance less than 20%, 28 could be interviewed. The interviews confirmed that lack of knowledge, distress and logistical problems resulted in non-compliance. Poor parental knowledge, distress and difficulties implementing treatment seemed to be associated with non-compliance. For the same domains, the scores were more favourable for families who had received the educational programme than for those who had not.

  11. Development, Implementation and Compliance of Treatment Pathways in Radiation Medicine

    Directory of Open Access Journals (Sweden)

    Louis ePotters

    2013-05-01

    Full Text Available INTRODUCTION: While much emphasis on safety in the radiation oncology clinic is placed on process, there remains considerable opportunity to increase safety, enhance outcomes and avoid ad-hoc care by instituting detailed treatment pathways. The purpose of this study was to review the process of developing evidence and consensus-based, outcomes-oriented treatment pathways that standardize treatment and patient management in a large multicenter radiation oncology practice. Further, we reviewed our compliance in incorporating these directives into our day-to-day clinical practice. METHODS: Using the Institute of Medicine guideline for developing treatment pathways, 87 disease specific pathways were developed and incorporated into the electronic medical system in our multi-facility radiation oncology department. Compliance in incorporating treatment pathways was assessed by mining our EMR data from January 1, 2010 through February 2012 for patients with breast and prostate cancer. RESULTS: This retrospective analysis of data from electronic medical records found overall compliance to breast and prostate cancer treatment pathways to be 97% and 99%, respectively. The reason for non-compliance proved to be either a failure to complete the prescribed care based on grade II or III toxicity (n=1 breast, 3 prostate or patient elected discontinuance of care (n=1 prostate or the physician chose a higher dose for positive/close margins (n=3 breast. CONCLUSION: This study demonstrates that consensus and evidence-based treatment pathways can be developed and implemented in a multi-center department of radiation oncology. And that for prostate and breast cancer there was a high degree of compliance using these directives. The development and implementation of these pathways serve as a key component of our safety program, most notably in our effort to facilitate consistent decision-making and reducing variation between physicians.

  12. From spoken narratives to domain knowledge: mining linguistic data for medical image understanding.

    Science.gov (United States)

    Guo, Xuan; Yu, Qi; Alm, Cecilia Ovesdotter; Calvelli, Cara; Pelz, Jeff B; Shi, Pengcheng; Haake, Anne R

    2014-10-01

    Extracting useful visual clues from medical images allowing accurate diagnoses requires physicians' domain knowledge acquired through years of systematic study and clinical training. This is especially true in the dermatology domain, a medical specialty that requires physicians to have image inspection experience. Automating or at least aiding such efforts requires understanding physicians' reasoning processes and their use of domain knowledge. Mining physicians' references to medical concepts in narratives during image-based diagnosis of a disease is an interesting research topic that can help reveal experts' reasoning processes. It can also be a useful resource to assist with design of information technologies for image use and for image case-based medical education systems. We collected data for analyzing physicians' diagnostic reasoning processes by conducting an experiment that recorded their spoken descriptions during inspection of dermatology images. In this paper we focus on the benefit of physicians' spoken descriptions and provide a general workflow for mining medical domain knowledge based on linguistic data from these narratives. The challenge of a medical image case can influence the accuracy of the diagnosis as well as how physicians pursue the diagnostic process. Accordingly, we define two lexical metrics for physicians' narratives--lexical consensus score and top N relatedness score--and evaluate their usefulness by assessing the diagnostic challenge levels of corresponding medical images. We also report on clustering medical images based on anchor concepts obtained from physicians' medical term usage. These analyses are based on physicians' spoken narratives that have been preprocessed by incorporating the Unified Medical Language System for detecting medical concepts. The image rankings based on lexical consensus score and on top 1 relatedness score are well correlated with those based on challenge levels (Spearman correlation>0.5 and Kendall

  13. Acid rain compliance planning using decision analysis

    International Nuclear Information System (INIS)

    Norris, C.; Sweet, T.; Borison, A.

    1991-01-01

    Illinois Power Company (IP) is an investor-owned electric and natural gas utility serving portions of downstate Illinois. In addition to one nuclear unit and several small gas and/or oil-fired units, IP has ten coal-fired units. It is easy to understand the impact the Clean Air Act Amendments of 1990 (CAAA) could have on IP. Prior to passage of the CAAA, IP formed several teams to evaluate the specific compliance options at each of the high sulfur coal units. Following that effort, numerous economic analyses of compliance strategies were conducted. The CAAA have introduced a new dimension to planning under uncertainty. Not only are many of the familiar variables uncertain, but the specific form of regulation, and indeed, the compliance goal itself is hard to define. For IP, this led them to use techniques not widely used within their corporation. This paper summarizes the analytical methods used in these analyses and the preliminary results as of July, 1991. The analysis used three approaches to examine the acid rain compliance decision. These approaches were: (1) the 'most-likely,' or single-path scenario approach; (2) a multi-path strategy analysis using the strategies defined in the single-scenario analysis; and (3) a less constrained multi-path option analysis which selects the least cost compliance option for each unit

  14. The practical outfall of DOE compliance agreements

    International Nuclear Information System (INIS)

    Smith, Leanne; Henrie, Gregory O.

    1992-01-01

    Perhaps the significant regulatory issue facing the Department of Energy (DOE or the Department) is the compliant treatment, storage, and disposal of mixed (radioactive and hazardous) waste. Since DOE'S By-Product Rulemaking in 1987, when the Department acknowledged that the Resource Conservation and Recovery Act (RCRA) applied to the hazardous component of mixed waste, DOE has repeatedly communicated to the Environmental Protection Agency (EPA) and host States that, for mixed waste, DOE is not always able to strictly comply with RCRA standards and that bringing treatment on-line in an expeditious manner is proving very difficult. One of the most effective methods used between DOE and its regulators to address mixed waste management issues is the negotiation of compliance agreements. These agreements establish formal mile stones for bringing DOE sites into compliance. The milestones are not completed without overcoming technical roadblocks and a struggle for funding. However, agreements can establish technically attainable compliance methods that take into account the special problems radiation introduces into RCRA waste management. Compliance agreements help promote a cooperative relationship within the Department and between DOE and its regulators in that all parties have reached agreement and have a stake in attaining the same goal. Where agreements exist, mixed waste compliance efforts can proceed in a situation where all parties have a full understanding of each other's needs and expectations. (author)

  15. Using interactive voice response to improve disease management and compliance with acute coronary syndrome best practice guidelines: A randomized controlled trial.

    Science.gov (United States)

    Sherrard, Heather; Duchesne, Lloyd; Wells, George; Kearns, Sharon Ann; Struthers, Christine

    2015-01-01

    There is evidence from large clinical trials that compliance with standardized best practice guidelines (BPGs) improves survival of acute coronary syndrome (ACS) patients. However, their application is often suboptimal. In this study, the researchers evaluated whether the use of an interactive voice response (IVR) follow-up system improved ACS BPG compliance. This was a single-centre randomized control trial (RCT) of 1,608 patients (IVR=803; usual care=805). The IVR group received five automated calls in 12 months. The primary composite outcome was increased medication compliance and decreased adverse events. A significant improvement of 60% in the IVR group for the primary composite outcome was found (RR 1.60, 95% CI: 1.29 to 2.00, p <0.001). There was significant improvement in medication compliance (p <0.001) and decrease in unplanned medical visits (p = 0.023). At one year, the majority of patients ( 85%) responded positively to using the system again. Follow-up by IVR produced positive outcomes in ACS patients.

  16. Medication compliance behavior in psychiatric out‑patients with ...

    African Journals Online (AJOL)

    Background: Psychotropic medication adherence is a major challenge in psychiatric patients with comorbidity. Objective: The objective was to determine medication adherence behavior among psychiatric out‑patients with psychoactive substance use comorbidity in a Nigerian Tertiary Hospital. Settings and Design: A ...

  17. Understanding the types of fraud in claims to South African medical schemes.

    Science.gov (United States)

    Legotlo, T G; Mutezo, A

    2018-03-28

    Medical schemes play a significant role in funding private healthcare in South Africa (SA). However, the sector is negatively affected by the high rate of fraudulent claims. To identify the types of fraudulent activities committed in SA medical scheme claims. A cross-sectional qualitative study was conducted, adopting a case study strategy. A sample of 15 employees was purposively selected from a single medical scheme administration company in SA. Semi-structured interviews were conducted to collect data from study participants. A thematic analysis of the data was done using ATLAS.ti software (ATLAS.ti Scientific Software Development, Germany). The study population comprised the 17 companies that administer medical schemes in SA. Data were collected from 15 study participants, who were selected from the medical scheme administrator chosen as a case study. The study found that medical schemes were defrauded in numerous ways. The perpetrators of this type of fraud include healthcare service providers, medical scheme members, employees, brokers and syndicates. Medical schemes are mostly defrauded by the submission of false claims by service providers and syndicates. Fraud committed by medical scheme members encompasses the sharing of medical scheme benefits with non-members (card farming) and non-disclosure of pre-existing conditions at the application stage. The study concluded that perpetrators of fraud have found several ways of defrauding SA medical schemes regarding claims. Understanding and identifying the types of fraud events facing medical schemes is the initial step towards establishing methods to mitigate this risk. Future studies should examine strategies to manage fraudulent medical scheme claims.

  18. Compliance of amblyopic patients with occlusion therapy: A pilot study

    Directory of Open Access Journals (Sweden)

    Sana Al-Zuhaibi

    2009-01-01

    Materials and Methods: A total of 31 families with a child (aged 2-12 years, undergoing unilateral amblyopia treatment at the pediatric ophthalmology clinic of Sultan Qaboos University Hospital, Oman, were recruited for this one month study. Parents were interviewed and completed a closed-ended questionnaire. Clinical data including, visual acuity, refraction, diagnosis and treatment, for each patient was collected from the hospital chart and was entered in a data collection sheet. Compliance with occlusion therapy was assessed by self-report accounts of parents and was graded into good, partial, or poor. Association between various factors and degree of compliance was studied using logistic regression modeling. Results: Only 14 (45% patients showed good compliance to occlusion therapy. 17 (55% patients were noncompliant. Improvement in visual acuity strongly correlated with compliance to patching (P = 0.008. Other variables that were studied included, age at onset of therapy; gender; degree of amblyopia; type of amblyopia; use of glasses; and compliance with glasses. These did not emerge as significant predictors of compliance. All but one family with poor compliance stated that the main challenge in following the recommendation to patch for requisite hours was in getting their child to cooperate. Only in one instance, the family cited nonavailability of patches as the main hindrance to compliance. 10/31 (32% families expressed a desire for more information and 18/31 (58% parents did not understand that amblyopia meant decreased vision. Conclusion: Poor compliance is a barrier to successful amblyopia therapy in our practice. Improvement in visual acuity is associated with better compliance with patching. Parents find it difficult to comprehend and retain verbal explanations of various components regarding occlusion therapy for amblyopia. Future study with a larger sample of patients is recommended to investigate the factors affecting compliance with amblyopia

  19. [Psychological factors associated to patient's treatment compliance in Chilean diabetic teenagers].

    Science.gov (United States)

    Ortiz, Manuel; Ortiz, Eugenia

    2005-03-01

    Treatment compliance among patients with type 1 diabetes mellitus, is low in 50% of diabetic teenagers, becoming a social and medical problem. To determine psycho-social factors associated to treatment compliance among Chilean diabetic type 1 teenagers. A non experimental study of 61 diabetic teenagers (age 14.9+/-1.9 years, 37 male). The number of blood glucose determinations, socioeconomic level and practice of sports was measured. Psychological tests were applied to analyze self-efficiency, motivation of achievement, self-esteem and knowledge of the illness and its treatment. As a measure of patient compliance, glycosilated hemoglobin (HB1Ac) was measured. Six patients had a good control of diabetes (HB1Ac <7%), 24 had HB1Ac values between 7 and 8.9, and 31 (51%) had values of 9% or more, considered as a poor diabetes control. The intensified insulin treatment scheme, the knowledge of the illness and its treatment and the sense of self-efficiency, were the factors associated with a better compliance with treatment. Teenagers of higher socio-economical levels had a better compliance with treatment. Fifty percent of Chilean diabetic teenagers in this sample had a poor control of the disease and the variable knowledge about the disease is the better predictor of patient compliance.

  20. THE ROLE OF LOCAL WISDOM TO TAX COMPLIANCE

    Directory of Open Access Journals (Sweden)

    I Nyoman Darmayasa

    2016-04-01

    Full Text Available Abstrak: Peran Kearifan Lokal Terhadap Kepatuhan Pajak. Penelitian ini bertujuan untuk memahami peran kearifan lokal terhadap kepatuhan pajak berdasar Self Assessment System (SAS di Lembaga Perkreditan Desa (LPD Legian Bali. Melalui paradigma interpretif dengan metode studi kasus, hasil penelitian menunjukkan bahwa makna kepatuhan pajak dideskripsikan sebagai kesadaran LPD untuk membayar pajak yang ditunjukkan melalui CSR berdasar Tri Hita Karana (THK. Implikasi teoretis dari penelitian ini terkait dengan makna dan perilaku kepatuhan pajak dari perspektif kearifan lokal. Hasil penelitian dapat dijadikan pertimbangan pembuat kebijakan untuk mempertimbangkan kearifan lokal dalam rangka meningkatkan kepatuhan pajak. Abstract: The Role of Local Wisdom on Tax Compliance. This study is intended to deepen our understanding about the meaning of the role of local wisdom on tax compliance in a village financing institution (LPD at Legian Bali. The research employed interpretive paradigm through case study. Results show that the meaning of tax compliance is described as awareness of LPD to pay taxes that is manifested in the implementation of CSR based on Tri Hita Karana (THK as local wisdom. Theoretical implications of this research is an alternative meaning and behavior of tax compliance from the perspective of local wisdom. The results can be used as consideration for taxation policy makers to raise local wisdom to encourage tax compliance.

  1. Post Implementation of Goods and Services Tax (GST) in Malaysia: Tax Agents’ Perceptions on Clients’ Compliance Behaviour and Tax Agents’ Roles in Promoting Compliance

    OpenAIRE

    Muhammad Izlawanie

    2017-01-01

    The Malaysian government introduced the Goods and Services Tax (GST) starting from 1 April 2015 to enhance the revenue collections and mitigate the transfer pricing manipulation. Tax agents play a significant role to help businesses to comply with GST law and regulations. After one year of GST implementation, it is vital to understand tax agents’ perceptions on clients’ compliance behaviour and tax agents’ roles in influencing compliance. A total of 30 registered tax agents completed a survey...

  2. A model-driven privacy compliance decision support for medical data sharing in Europe.

    Science.gov (United States)

    Boussi Rahmouni, H; Solomonides, T; Casassa Mont, M; Shiu, S; Rahmouni, M

    2011-01-01

    Clinical practitioners and medical researchers often have to share health data with other colleagues across Europe. Privacy compliance in this context is very important but challenging. Automated privacy guidelines are a practical way of increasing users' awareness of privacy obligations and help eliminating unintentional breaches of privacy. In this paper we present an ontology-plus-rules based approach to privacy decision support for the sharing of patient data across European platforms. We use ontologies to model the required domain and context information about data sharing and privacy requirements. In addition, we use a set of Semantic Web Rule Language rules to reason about legal privacy requirements that are applicable to a specific context of data disclosure. We make the complete set invocable through the use of a semantic web application acting as an interactive privacy guideline system can then invoke the full model in order to provide decision support. When asked, the system will generate privacy reports applicable to a specific case of data disclosure described by the user. Also reports showing guidelines per Member State may be obtained. The advantage of this approach lies in the expressiveness and extensibility of the modelling and inference languages adopted and the ability they confer to reason with complex requirements interpreted from high level regulations. However, the system cannot at this stage fully simulate the role of an ethics committee or review board.

  3. The Amsterdam Hip Protector Study: Compliance and determinants of compliance

    NARCIS (Netherlands)

    van Schoor, N.M.; Asma, G.; Smit, J.H.; Bouter, L.M.; Lips, P.T.A.M.

    2003-01-01

    Hip protectors appear to be effective in reducing the incidence of hip fractures. However, compliance is often poor. Therefore, the objective of this study was to examine the compliance and determinants of compliance with external hip protectors. A prospective study was performed in residents from

  4. Improving ambulatory saliva-sampling compliance in pregnant women: a randomized controlled study.

    Directory of Open Access Journals (Sweden)

    Julian Moeller

    Full Text Available OBJECTIVE: Noncompliance with scheduled ambulatory saliva sampling is common and has been associated with biased cortisol estimates in nonpregnant subjects. This study is the first to investigate in pregnant women strategies to improve ambulatory saliva-sampling compliance, and the association between sampling noncompliance and saliva cortisol estimates. METHODS: We instructed 64 pregnant women to collect eight scheduled saliva samples on two consecutive days each. Objective compliance with scheduled sampling times was assessed with a Medication Event Monitoring System and self-reported compliance with a paper-and-pencil diary. In a randomized controlled study, we estimated whether a disclosure intervention (informing women about objective compliance monitoring and a reminder intervention (use of acoustical reminders improved compliance. A mixed model analysis was used to estimate associations between women's objective compliance and their diurnal cortisol profiles, and between deviation from scheduled sampling and the cortisol concentration measured in the related sample. RESULTS: Self-reported compliance with a saliva-sampling protocol was 91%, and objective compliance was 70%. The disclosure intervention was associated with improved objective compliance (informed: 81%, noninformed: 60%, F(1,60  = 17.64, p<0.001, but not the reminder intervention (reminders: 68%, without reminders: 72%, F(1,60 = 0.78, p = 0.379. Furthermore, a woman's increased objective compliance was associated with a higher diurnal cortisol profile, F(2,64  = 8.22, p<0.001. Altered cortisol levels were observed in less objective compliant samples, F(1,705  = 7.38, p = 0.007, with delayed sampling associated with lower cortisol levels. CONCLUSIONS: The results suggest that in pregnant women, objective noncompliance with scheduled ambulatory saliva sampling is common and is associated with biased cortisol estimates. To improve sampling compliance, results suggest

  5. Prevention of DNA contamination during forensic medical examinations in a clinical forensic medical service: A best practice implementation project.

    Science.gov (United States)

    Lutz, Tasha

    2015-01-01

    Contamination of forensic specimens can have significant and detrimental effects on cases presented in court. In 2010 a wrongful conviction in Australia resulted in an inquiry with 25 recommendations to minimize the risk of DNA contamination of forensic specimens. DNA decontamination practices in a clinical forensic medical service currently attempt to comply with these recommendations. Evaluation of these practices has not been undertaken. The aim of this project was to audit the current DNA decontamination practices of forensic medical and nursing examiners in the forensic medical examination process and implement changes based on the audit findings. A re-audit following implementation would be undertaken to identify change and inform further research. The Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research into Practice were used as the audit tool in this project. A baseline audit was conducted; analysis of this audit process was then undertaken. Following education and awareness training targeted at clinicians, a re-audit was completed. There were a total of 24 audit criteria; the baseline audit reflected 20 of these criteria had 100% compliance. The remaining 4 audit criteria demonstrated compliance between 65% and 90%. Education and awareness training resulted in improved compliance in 2 of the 4 audit criteria, with the remaining 2 having unchanged compliance. The findings demonstrated that education and raising awareness can improve clinical practice; however there are also external factors outside the control of the clinicians that influence compliance with best practice.

  6. Poster — Thur Eve — 50: Common Regulatory Non-Compliances and How to Avoid Them

    Energy Technology Data Exchange (ETDEWEB)

    Heimann, M.

    2014-08-15

    The Accelerators and Class II Facilities Division (ACFD) of the Canadian Nuclear Safety Commission (CNSC), is responsible for the oversight of radiotherapy facilities containing Class II prescribed equipment in Canada. Over the past several years, ACFD has been performing compliance inspections of Class II nuclear facilities across the country (medical and otherwise), and in that time, has issued several hundred corrective actions to licensees due to non-compliance with regulatory requirements. Recently, a study was done to determine the most common regulatory non-compliances. The purpose of this poster presentation is to disseminate information to the licensee community about the nature of these non-compliances, and how they can be avoided by licensees in the future.

  7. Dietary compliance among diabetes patients attending clinic at new ...

    African Journals Online (AJOL)

    Background: Diabetes Mellitus is a major public health issue. It is one of the most prevalent medical conditions affecting people and is responsible for high mortality and large amount of potential years of life lost. Diet is the cornerstone of diabetes management, without which its control is impossible. However, compliance to ...

  8. The Mental Health Care Act: Stakeholder compliance with Section ...

    African Journals Online (AJOL)

    Objective. To determine compliance with Section 40 (1-3) of the Mental Health Care Act (MHCA) No 17 of 2002, viz. handing over custody by the South African Police Service (SAPS) of suspected mentally ill patients to medical services at Chris Hani Baragwanath Hospital (CHBH). Methods. The study was a retrospective ...

  9. Context and clinical reasoning : Understanding the medical student perspective.

    Science.gov (United States)

    McBee, Elexis; Ratcliffe, Temple; Schuwirth, Lambert; O'Neill, Daniel; Meyer, Holly; Madden, Shelby J; Durning, Steven J

    2018-04-27

    Studies have shown that a physician's clinical reasoning performance can be influenced by contextual factors. We explored how the clinical reasoning performance of medical students was impacted by contextual factors in order to expand upon previous findings in resident and board certified physicians. Using situated cognition as the theoretical framework, our aim was to evaluate the verbalized clinical reasoning processes of medical students in order to describe what impact the presence of contextual factors has on their reasoning performance. Seventeen medical student participants viewed three video recordings of clinical encounters portraying straightforward diagnostic cases in internal medicine with explicit contextual factors inserted. Participants completed a computerized post-encounter form as well as a think-aloud protocol. Three authors analyzed verbatim transcripts from the think-aloud protocols using a constant comparative approach. After iterative coding, utterances were analyzed and grouped into categories and themes. Six categories and ten associated themes emerged, which demonstrated overlap with findings from previous studies in resident and attending physicians. Four overlapping categories included emotional disturbances, behavioural inferences about the patient, doctor-patient relationship, and difficulty with closure. Two new categories emerged to include anchoring and misinterpretation of data. The presence of contextual factors appeared to impact clinical reasoning performance in medical students. The data suggest that a contextual factor can be innate to the clinical scenario, consistent with situated cognition theory. These findings build upon our understanding of clinical reasoning performance from both a theoretical and practical perspective.

  10. Type 2 diabetes patients' and providers' differing perspectives on medication nonadherence: a qualitative meta-synthesis.

    Science.gov (United States)

    Brundisini, Francesca; Vanstone, Meredith; Hulan, Danielle; DeJean, Deirdre; Giacomini, Mita

    2015-11-23

    Poor adherence to medication regimens increases adverse outcomes for patients with Type 2 diabetes. Improving medication adherence is a growing priority for clinicians and health care systems. We examine the differences between patient and provider understandings of barriers to medication adherence for Type 2 diabetes patients. We searched systematically for empirical qualitative studies on the topic of barriers to medication adherence among Type 2 diabetes patients published between 2002-2013; 86 empirical qualitative studies qualified for inclusion. Following qualitative meta-synthesis methods, we coded and analyzed thematically the findings from studies, integrating and comparing findings across studies to yield a synthetic interpretation and new insights from this body of research. We identify 7 categories of barriers: (1) emotional experiences as positive and negative motivators to adherence, (2) intentional non-compliance, (3) patient-provider relationship and communication, (4) information and knowledge, (5) medication administration, (6) social and cultural beliefs, and (7) financial issues. Patients and providers express different understandings of what patients require to improve adherence. Health beliefs, life context and lay understandings all inform patients' accounts. They describe barriers in terms of difficulties adapting medication regimens to their lifestyles and daily routines. In contrast, providers' understandings of patients poor medication adherence behaviors focus on patients' presumed needs for more information about the physiological and biomedical aspect of diabetes. This study highlights key discrepancies between patients' and providers' understandings of barriers to medication adherence. These misunderstandings span the many cultural and care contexts represented by 86 qualitative studies. Counseling and interventions aimed at improving medication adherence among Type 2 diabetes might become more effective through better integration of

  11. Medication understanding, non-adherence, and clinical outcomes among adult kidney transplant recipients.

    Science.gov (United States)

    Patzer, Rachel E; Serper, Marina; Reese, Peter P; Przytula, Kamila; Koval, Rachel; Ladner, Daniela P; Levitsky, Josh M; Abecassis, Michael M; Wolf, Michael S

    2016-10-01

    We sought to evaluate the prevalence of medication understanding and non-adherence of entire drug regimens among kidney transplantation (KT) recipients and to examine associations of these exposures with clinical outcomes. Structured, in-person interviews were conducted with 99 adult KT recipients between 2011 and 2012 at two transplant centers in Chicago, IL; and Atlanta, GA. Nearly, one-quarter (24%) of participants had limited literacy as measured by the Rapid Estimate of Adult Literacy in Medicine test; patients took a mean of 10 (SD=4) medications and 32% had a medication change within the last month. On average, patients knew what 91% of their medications were for (self-report) and demonstrated proper dosing (via observed demonstration) for 83% of medications. Overall, 35% were non-adherent based on either self-report or tacrolimus level. In multivariable analyses, fewer months since transplant and limited literacy were associated with non-adherence (all Padherence, and hospitalization could help target appropriate self-care interventions. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Understanding rational non-adherence to medications. A discrete choice experiment in a community sample in Australia

    Directory of Open Access Journals (Sweden)

    Laba Tracey-Lea

    2012-06-01

    Full Text Available Abstract Background In spite of the potential impact upon population health and expenditure, interventions promoting medication adherence have been found to be of moderate effectiveness and cost effectiveness. Understanding the relative influence of factors affecting patient medication adherence decisions and the characteristics of individuals associated with variation in adherence will lead to a better understanding of how future interventions should be designed and targeted. This study aims to explore medication-taking decisions that may underpin intentional medication non-adherence behaviour amongst a community sample and the relative importance of medication specific factors and patient background characteristics contributing to those decisions. Methods A discrete choice experiment conducted through a web-enabled online survey was used to estimate the relative importance of eight medication factors (immediate and long-term medication harms and benefits, cost, regimen, symptom severity, alcohol restrictions on the preference to continue taking a medication. To reflect more closely what usually occurs in practice, non-disease specific medication and health terms were used to mimic decisions across multiple medications and conditions.161 general community participants, matching the national Australian census data (age, gender were recruited through an online panel provider (participation rate: 10% in 2010. Results Six of the eight factors (i.e. immediate and long-term medication harms and benefits, cost, and regimen had a significant influence on medication choice. Patient background characteristics did not improve the model. Respondents with private health insurance appeared less sensitive to cost then those without private health insurance. In general, health outcomes, framed as a side-effect, were found to have a greater influence over adherence than outcomes framed as therapeutic benefits. Conclusions Medication-taking decisions are the

  13. Understanding rational non-adherence to medications. A discrete choice experiment in a community sample in Australia.

    Science.gov (United States)

    Laba, Tracey-Lea; Brien, Jo-Anne; Jan, Stephen

    2012-06-20

    In spite of the potential impact upon population health and expenditure, interventions promoting medication adherence have been found to be of moderate effectiveness and cost effectiveness. Understanding the relative influence of factors affecting patient medication adherence decisions and the characteristics of individuals associated with variation in adherence will lead to a better understanding of how future interventions should be designed and targeted. This study aims to explore medication-taking decisions that may underpin intentional medication non-adherence behaviour amongst a community sample and the relative importance of medication specific factors and patient background characteristics contributing to those decisions. A discrete choice experiment conducted through a web-enabled online survey was used to estimate the relative importance of eight medication factors (immediate and long-term medication harms and benefits, cost, regimen, symptom severity, alcohol restrictions) on the preference to continue taking a medication. To reflect more closely what usually occurs in practice, non-disease specific medication and health terms were used to mimic decisions across multiple medications and conditions.161 general community participants, matching the national Australian census data (age, gender) were recruited through an online panel provider (participation rate: 10%) in 2010. Six of the eight factors (i.e. immediate and long-term medication harms and benefits, cost, and regimen) had a significant influence on medication choice. Patient background characteristics did not improve the model. Respondents with private health insurance appeared less sensitive to cost then those without private health insurance. In general, health outcomes, framed as a side-effect, were found to have a greater influence over adherence than outcomes framed as therapeutic benefits. Medication-taking decisions are the subject of rational choices, influenced by the attributes of

  14. Role of health education and self-action plan in improving the drug compliance in bronchial asthma.

    Science.gov (United States)

    Gaude, Gajanan S; Hattiholi, Jyothi; Chaudhury, Alisha

    2014-01-01

    Considering the prevalence and associated burden of disease due to bronchial asthma, it is mandatory to obtain an optimal control of the disease and to improve outcomes for these patients. But it has been observed that there is very poor adherence to the inhalational therapy which leads to the suboptimal control of the disease. To study the adherence for aerosol therapy in bronchial asthma patients and to assess the impact of health education and self-action plan in improving the compliance to the therapy. A prospective study was done in a total of 500 bronchial asthma patients over a period of 2 years. Once included in the study, the patients were followed-up for a total of 12 weeks for calculation of nonadherence to the aerosol therapy. In nonadherent patients, we employed various health education strategies to improve the compliance in these cases. A total of 500 patients of bronchial asthma who were started on aerosol therapy over duration of 2 years were included in the study. At the end of 12 weeks, it was observed that, only 193 patients (38.6%) had regular compliance and 307 patients (61.4%) were noncompliant to aerosol therapy as prescribed for bronchial asthma. Factors that were associated with poor compliance were: Lower educational level status, poor socioeconomic status, cumbersome regimens, dislike of medication, and distant pharmacies. Nondrug factors that reduced the compliance were: Fears about side effects, anger about condition or its treatment, forgetfulness or complacency, and patient's ill attitudes toward health. After employing the various strategies for improving the compliance in these patients, the compliance increased in 176 patients (57.3%) among the earlier defaulted patients, while the remaining 131 patients (42.7%) were found to be noncompliant even after various educational techniques. Noncompliance in asthma management is a fact of life and no single compliance improving strategy probably will be as effective as a good physician

  15. Brand names of Portuguese medication: understanding the importance of their linguistic structure and regulatory issues.

    Science.gov (United States)

    Pires, Carla; Vigário, Marina; Cavaco, Afonso

    2015-08-01

    Among other regulatory requirements, medicine brands should be composed of single names without abbreviations to prevent errors in prescription of medication. The purposes of the study were to investigate the compliance of a sam ple of Portuguese medicine brand names with Portuguese pharmaceutical regulations. This includes identifying their basic linguistic characteristics and comparing these features and their frequency of occurrence with benchmark values of the colloquial or informal language. A sample of 474 brand names was selected. Names were analyzed using manual (visual analyses) and computer methods (FreP - Frequency Patterns of Phonological Objects in Portuguese and MS word). A significant number of names (61.3%) failed to comply with the Portuguese phonologic system (related to the sound of words) and/or the spelling system (related to the written form of words) contained more than one word, comprised a high proportion of infrequent syllable types or stress patterns and included abbreviations. The results suggest that some of the brand names of Portuguese medication should be reevaluated, and that regulation on this issue should be enforced and updated, taking into consideration specific linguistic and spelling codes.

  16. Environmental Compliance Mechanisms

    NARCIS (Netherlands)

    Merkouris, Panagiotis; Fitzmaurice, Malgosia

    2017-01-01

    Compliance mechanisms can be found in treaties regulating such diverse issues as human rights, disarmament law, and environmental law. In this bibliography, the focus will be on compliance mechanisms of multilateral environmental agreements (MEAs). Compliance with norms of international

  17. Burnout syndrome: understanding of medical teaching professionals

    Directory of Open Access Journals (Sweden)

    Jaqueline Brito Vidal Batista

    2017-04-01

    Full Text Available This study aimed to investigate the understanding of medical teaching professionals about Burnout Syndrome. This is a qualitative, exploratory study, consisting of ten teaching physicians, who work at the hospital of a higher education institution. The data were collected from May to June 2013, through a form with questions pertinent to the proposed research objective, after approval by the Research Ethics Committee (Protocol No. 84022, and analyzed qualitatively, through the content analysis technique (Bardin. Among the 10 participants in the study, eight had adequate knowledge about Burnout Syndrome, while others showed insufficient knowledge. From the empirical material analysis, five thematic categories emerged: Syndrome characterized by physical and psychological exhaustion due to work stress; Physical and psychological signs and symptoms of Burnout Syndrome; Burnout syndrome and its implications for the worker’s health; The most vulnerable workers who develop Burnout Syndrome and Relation of Burnout Syndrome to the work of the teaching physician. The study showed that most participants in the research adequately understand Burnout Syndrome, but the subject is still little explored in academia. Therefore, intervention measures are necessary with the professionals of the risk group and new studies that contribute to expand the knowledge about that syndrome, aiming to improve the quality of life of the workers. Keywords: Worker’s Health; Professional Exhaustion; Doctors; Professors; Work Conditions.   DOI: http://dx.doi.org/10.3823/2397

  18. Paediatric nurses' understanding of the process and procedure of double-checking medications.

    Science.gov (United States)

    Dickinson, Annette; McCall, Elaine; Twomey, Bernadette; James, Natalie

    2010-03-01

    To understand paediatric nurses' understanding and practice regarding double-checking medication and identify facilitators and barriers to the process of independent double-checking (IDC). A system of double-checking medications has been proposed as a way of minimising medication error particularly in situations involving high-risk medications, complex processes such as calculating doses, or high-risk patient populations such as infants and children. While recommendations have been made in support of IDC in paediatric settings little is known about nursing practice and the facilitators and barriers to this process. A descriptive qualitative design was used. Data were collected via three focus group interviews. Six to seven paediatric nurses participated in homogenous groups based on level of practice. Data were analysed using thematic analysis. This study demonstrates that, while IDC is accepted and promoted as best practice in a paediatric setting, there is a lack of clarity as to what this means. This study supports other studies in relation to the influence of workload, distraction and environmental factors on the administration process but highlights the need for more research in relation to the impact of the power dynamic between junior and senior nurses. The issue of automaticity has been unexplored in relation to nursing practice but this study indicates that this may have an important influence on how care is delivered to patients. While the focus of this study was in the paediatric setting, the findings have relevance to other settings and population groups. The adoption of IDC in health care settings must have in place: policy and guidelines that clearly define the process of checking, educational support, an environment that supports peer critique and review, well-designed medication areas and accessible resources to support drug administration.

  19. Determinants of compliance with malaria chemoprophylaxis among French soldiers during missions in inter-tropical Africa

    Directory of Open Access Journals (Sweden)

    Pradines Bruno

    2010-02-01

    Full Text Available Abstract Background The effectiveness of malaria chemoprophylaxis is limited by the lack of compliance whose determinants are not well known. Methods The compliance with malaria chemoprophylaxis has been estimated and analysed by validated questionnaires administered before and after the short-term missions (about four months in five tropical African countries of 2,093 French soldiers from 19 military companies involved in a prospective cohort study. "Correct compliance" was defined as "no missed doses" of daily drug intake during the entire mission and was analysed using multiple mixed-effect logistic regression model. Results The averaged prevalence rate of correct compliance was 46.2%, ranging from 9.6%to 76.6% according to the companies. Incorrect compliance was significantly associated with eveningness (p = 0.028, a medical history of clinical malaria (p Conclusions The identification of circumstances and profiles of persons at higher risk of lack of compliance would pave the way to specifically targeted strategies aimed to improve compliance with malaria chemoprophylaxis and, therefore, its effectiveness.

  20. Impact of physician empathy on migraine disability and migraineur compliance

    Directory of Open Access Journals (Sweden)

    Hatim S Attar

    2012-01-01

    Full Text Available Aims: We aim to establish the role that perceived physician empathy plays in determining migraineurs′ outcomes and compliance with migraine management plans. We checked for associations between perceived physician empathy and clinical outcomes as well as compliance with management plans. Materials and Methods: 63 migraineurs were enrolled between July and September 2011. Questionnaire administered at the time of inclusion into the study included self-assessment of disability due to migraine (Migraine Disability Assessment Test followed by migraineurs′ assessment of physician empathy (Consultation and Relational Empathy Measure. Three months later, a telephonic questionnaire ascertained changes in disability due to migraine and compliance with migraine treatment. Statistical Analysis: Data was entered in Microsoft Excel 2010 and analyzed using SPSS 17. Pearson′s correlation was employed to analyze the significance of relationship between variables. P-value of less than 0.05 has been considered statistically significant. Results: Statistically significant positive Pearson′s correlations are seen between perceived empathy and decrease in migraine disability and symptoms over three months (P < 0.05. Significant positive relationships are also seen between perceived empathy and compliance with diet/meal timings, exercising, de-stressing/sleep pattern modification and medications (P < 0.05. Self-reported compliance is significantly correlated with improved patient outcomes (P < 0.05. Conclusions: Substantial positive associations are found between perceived physician empathy and migraineurs′ outcomes and compliance with management plans. This emphasizes the importance of empathy in migraineur-physician communication.

  1. Use of Monte Carlo modeling approach for evaluating risk and environmental compliance

    International Nuclear Information System (INIS)

    Higley, K.A.; Strenge, D.L.

    1988-09-01

    Evaluating compliance with environmental regulations, specifically those regulations that pertain to human exposure, can be a difficult task. Historically, maximum individual or worst-case exposures have been calculated as a basis for evaluating risk or compliance with such regulations. However, these calculations may significantly overestimate exposure and may not provide a clear understanding of the uncertainty in the analysis. The use of Monte Carlo modeling techniques can provide a better understanding of the potential range of exposures and the likelihood of high (worst-case) exposures. This paper compares the results of standard exposure estimation techniques with the Monte Carlo modeling approach. The authors discuss the potential application of this approach for demonstrating regulatory compliance, along with the strengths and weaknesses of the approach. Suggestions on implementing this method as a routine tool in exposure and risk analyses are also presented. 16 refs., 5 tabs

  2. Quality of life and compliance in geriatric patients

    Directory of Open Access Journals (Sweden)

    Igor Kalugin

    2017-09-01

    Full Text Available Background. Older adults usually have more than one chronic disease. In most cases, each condition requires constant pharmacotherapy. On average, the clinical examination of patients aged 60 and older reveals at least four or five different chronic pathological states in various phases and stages. Disease interference changes the classical clinical picture, increases the number of complications and their severity, affects the quality of life and prognosis, as a result - complicated medical diagnostic process and reduced compliance. The presence in the elderly both mental and physical illness significantly affects the quality of life. Psychological interventions aimed at a patient's awareness of the disease and methods of its treatment, the creation of therapeutic alliance and the prevention of self-medication, according to our hypothesis, contributes to compliance and quality of life improvement in polymorbid elderly patients suffering from mental disorders. Methods. In the study took part 325 patients who underwent inpatient treatment at the gerontopsychiatric department and signed provided informed consent. The study had a design of a randomized controlled clinical trial. Patients were randomized to experimental and control groups in a ratio of 3 to 1 based on age and gender. The study group of 238 people received standard treatment and psychological interventions. A comparison group of 87 people had only standard treatment. Patients were evaluated for quality of life with SF-36 scale and compliance with Morisky Medication Adherence Scale. Results. We have seen significant intergroup differences on the Morisky Medication Adherence Scale in the baseline period. Consequently, its results were not be taken into account in the final analysis. Before treatment patients’ quality of life between the study groups did not differ statistically (p = 0.317. After the treatment, a statistically significant difference in life quality between experimental

  3. ENHANCING VOLUNTARY COMPLIANCE BY REDUCING COMPLIANCE COSTS: A TAXPAYER SERVICE APPROACH

    OpenAIRE

    Glenn Jenkins; EDWIN FORLEMU

    1993-01-01

    In this paper an overview is made of the determinants of voluntary tax compliance. Unlike previous treatments of this subject, the cost of taxpayer compliance is considered as an important determinant of overall level of voluntary compliance in a country. A number of ways that tax authorities reduce compliance are discussed, and the most common uses of information technology in providing taxpayer service is described. Finally, the paper considers some of the ways that such activities might be...

  4. Compliance and persistence of antidepressants versus anticonvulsants in patients with neuropathic pain during the first year of therapy.

    Science.gov (United States)

    Gharibian, Derenik; Polzin, Jennifer K; Rho, Jay P

    2013-05-01

    Neuropathic pain (NP) is a chronic condition that has human, social, and economic consequences. A variety of agents can be used for treatment; however, antidepressants and anticonvulsants are the 2 classes most widely studied and represent first-line agents in the management of NP. Little information is known about the adherence patterns of these medications during the first year of therapy in patients with NP. To examine the compliance and persistence of antidepressants versus anticonvulsants in patients with NP during the first year of therapy. Using electronic medical and pharmacy data for the Kaiser Permanente Southern California region, the adherence patterns for patients with a NP diagnosis prescribed an antidepressant or an anticonvulsant were studied. Compliance and persistence were measured using the medication possession ratio and the Refill-Sequence model, respectively. The study included 1817 patients with NP diagnosis taking either an antidepressant or an anticonvulsant. Within the antidepressant group, 42.9% were considered compliant, compared with 43.7% in the anticonvulsant group. Subanalysis of the 2 cohorts revealed that patients on venlafaxine were the most compliant (69.4%) compared with patients taking gabapentin (44.4%) and tricyclic antidepressants (41.8%) (Panticonvulsant group were considered persistent with their medication refills. Compliance and persistence rates were similar for patients with NP diagnosis taking antidepressants and anticonvulsants. Higher compliance was observed among patients taking venlafaxine; however, this population did have a small sample size.

  5. Perspectives on compliance: non-compliance with environmental licenses in the Netherlands

    NARCIS (Netherlands)

    van Snellenberg, A.H.L.M.; van de Peppel, R.A.

    2002-01-01

    Compliance with environmental law is not self-evident. In many instances enforcement of environmental regulations is a necessary means for achieving compliance. Assuming that an enforcement strategy, in order to be effective, has to fit the type of non-compliance, we integrate six different

  6. Case outsourcing medical device reprocessing.

    Science.gov (United States)

    Haley, Deborah

    2004-04-01

    IN THE INTEREST OF SAVING MONEY, many hospitals are considering extending the life of some single-use medical devices by using medical device reprocessing programs. FACILITIES OFTEN LACK the resources required to meet the US Food and Drug Administration's tough quality assurance standards. BY OUTSOURCING, hospitals can reap the benefits of medical device reprocessing without assuming additional staffing and compliance burdens. OUTSOURCING enables hospitals to implement a medical device reprocessing program quickly, with no capital investment and minimal effort.

  7. Criminal Compliance

    Directory of Open Access Journals (Sweden)

    Cristina Antonella Andretta

    2015-10-01

    The article discusses the concepts of both compliance and criminal compliance, its main components and structure as well as the main rules relating to its global application, and finally his emergence in the Ecuadorian legal system.

  8. Shared decision making and medication management in the recovery process.

    Science.gov (United States)

    Deegan, Patricia E; Drake, Robert E

    2006-11-01

    Mental health professionals commonly conceptualize medication management for people with severe mental illness in terms of strategies to increase compliance or adherence. The authors argue that compliance is an inadequate construct because it fails to capture the dynamic complexity of autonomous clients who must navigate decisional conflicts in learning to manage disorders over the course of years or decades. Compliance is rooted in medical paternalism and is at odds with principles of person-centered care and evidence-based medicine. Using medication is an active process that involves complex decision making and a chance to work through decisional conflicts. It requires a partnership between two experts: the client and the practitioner. Shared decision making provides a model for them to assess a treatment's advantages and disadvantages within the context of recovering a life after a diagnosis of a major mental disorder.

  9. The New World of Interaction Recording for Medical Practices.

    Science.gov (United States)

    Levy, Michael

    2016-01-01

    Today's medical practice staff communicates remotely with patients, pharmacies, and other medical providers in new ways that go far beyond telephone calls. Patient care and communication are now being provided via telecommunications technologies, including chat/IM, screen, Skype, and other video applications. This new paradigm in patient care, known as "telehealth" or "telemedicine," could put medical practices at risk for noncompliance with strict HIPAA and other regulations. Interaction recording encompasses these new means of communication and can help medical practice staff achieve compliance and reduce financial and liability risks while improving operations and patient care. This article explores what medical practices need to know about interaction recording, what to look for in an interaction recording solution, and how to best utilize that solution to meet compliance, manage liability, and improve patient care.

  10. Use of electronic medical record-enhanced checklist and electronic dashboard to decrease CLABSIs.

    Science.gov (United States)

    Pageler, Natalie M; Longhurst, Christopher A; Wood, Matthew; Cornfield, David N; Suermondt, Jaap; Sharek, Paul J; Franzon, Deborah

    2014-03-01

    We hypothesized that a checklist enhanced by the electronic medical record and a unit-wide dashboard would improve compliance with an evidence-based, pediatric-specific catheter care bundle and decrease central line-associated bloodstream infections (CLABSI). We performed a cohort study with historical controls that included all patients with a central venous catheter in a 24-bed PICU in an academic children's hospital. Postintervention CLABSI rates, compliance with bundle elements, and staff perceptions of communication were evaluated and compared with preintervention data. CLABSI rates decreased from 2.6 CLABSIs per 1000 line-days before intervention to 0.7 CLABSIs per 1000 line-days after intervention. Analysis of specific bundle elements demonstrated increased daily documentation of line necessity from 30% to 73% (P < .001), increased compliance with dressing changes from 87% to 90% (P = .003), increased compliance with cap changes from 87% to 93% (P < .001), increased compliance with port needle changes from 69% to 95% (P < .001), but decreased compliance with insertion bundle documentation from 67% to 62% (P = .001). Changes in the care plan were made during review of the electronic medical record checklist on 39% of patient rounds episodes. Use of an electronic medical record-enhanced CLABSI prevention checklist coupled with a unit-wide real-time display of adherence was associated with increased compliance with evidence-based catheter care and sustained decrease in CLABSI rates. These data underscore the potential for computerized interventions to promote compliance with proven best practices and prevent patient harm.

  11. The Relationship between Stroke Patients Characteristics and Family Support with Compliance Rehabilitation

    Directory of Open Access Journals (Sweden)

    Irma Okta Wardhani

    2015-01-01

    Full Text Available Stroke is a cerebrovascular disease, it is brain function disorders associated with the disease of the blood vessels that supply the brain. The impact of stroke is paralysis. Family support is things that are needed to be considered in the treatment of stroke patients. It is very involved in the compliance rehabilitation of patients to prevent the re-occurrence of stroke. Characteristics of stroke patients may also affect the compliance rehabilitation. The purpose of this research is to determine the relationship between stroke patients characteristics and family support to compliance rehabilitation at the Medical Rehabilitation Unit RSU Haji Surabaya. This research was an analytic observational research with cross sectional design. The subjects of this research are taken using total population technique. The independent variables in this research is family support. The dependent variable is compliance rehabilitation. The results of this research are presented in the form of frequency distributions and calculate the strength of the relationship with Phi coefficient. The result of this research shows that there is a strong relationship between family support and compliance rehabilitation (r=0.582. There are weak relationship between ages (r=-0,027, gender (r=0,092, level of education (r= -0,295, work (r=0,098, and marital status (r=0,319. The conclusion is family support may affect compliance rehabilitation of stroke patients. It is recommended for health workers to provide counseling to improve family support in curing stroke patients. Keywords: depression, family support, compliance rehabilitation

  12. Developing medical device software in compliance with regulations.

    Science.gov (United States)

    Zema, M; Rosati, S; Gioia, V; Knaflitz, M; Balestra, G

    2015-08-01

    In the last decade, the use of information technology (IT) in healthcare has taken a growing role. In fact, the adoption of an increasing number of computer tools has led to several benefits related to the process of patient care and allowed easier access to social and health care resources. At the same time this trend gave rise to new challenges related to the implementation of these new technologies. Software used in healthcare can be classified as medical devices depending on the way they are used and on their functional characteristics. If they are classified as medical devices they must satisfy specific regulations. The aim of this work is to present a software development framework that can allow the production of safe and high quality medical device software and to highlight the correspondence between each software development phase and the appropriate standard and/or regulation.

  13. Applying the Analytic Hierarchy Process to Oil Sands Environmental Compliance Risk Management

    Science.gov (United States)

    Roux, Izak Johannes, III

    Oil companies in Alberta, Canada, invested $32 billion on new oil sands projects in 2013. Despite the size of this investment, there is a demonstrable deficiency in the uniformity and understanding of environmental legislation requirements that manifest into increased project compliance risks. This descriptive study developed 2 prioritized lists of environmental regulatory compliance risks and mitigation strategies and used multi-criteria decision theory for its theoretical framework. Information from compiled lists of environmental compliance risks and mitigation strategies was used to generate a specialized pairwise survey, which was piloted by 5 subject matter experts (SMEs). The survey was validated by a sample of 16 SMEs, after which the Analytic Hierarchy Process (AHP) was used to rank a total of 33 compliance risks and 12 mitigation strategy criteria. A key finding was that the AHP is a suitable tool for ranking of compliance risks and mitigation strategies. Several working hypotheses were also tested regarding how SMEs prioritized 1 compliance risk or mitigation strategy compared to another. The AHP showed that regulatory compliance, company reputation, environmental compliance, and economics ranked the highest and that a multi criteria mitigation strategy for environmental compliance ranked the highest. The study results will inform Alberta oil sands industry leaders about the ranking and utility of specific compliance risks and mitigations strategies, enabling them to focus on actions that will generate legislative and public trust. Oil sands leaders implementing a risk management program using the risks and mitigation strategies identified in this study will contribute to environmental conservation, economic growth, and positive social change.

  14. A Prospective Randomized Trial on the Effect of Using an Electronic Monitoring Drug Dispensing Device to Improve Adherence and Compliance.

    Science.gov (United States)

    Henriksson, Jarmo; Tydén, Gunnar; Höijer, Jonas; Wadström, Jonas

    2016-01-01

    Outcome after renal transplantation depends on patient compliance and adherence for early detection of complications and identification of intervention opportunities. Compliance describes the degree to which patients follow medical advice and take their medications. Adherence has been defined as the extent to which a patients' behavior coincides with clinical prescriptions. Patients were randomized 7 to 14 days after transplantation into groups with (n = 40) and without (n = 40) an electronic medication dispenser (EMD). The EMD, which was used for the 1-year study period, recorded the date and time the patient took their medications and was monitored via a web-based application. Patients were monitored for 1 year regarding outpatient follow-up visits, emergency hospitalizations, renal biopsies, rejection episodes, renal function, and blood concentration of medications. Compliance in the intervention group was 97.8% (the control group was not assessed). Number of missed doses varied significantly by weekday (P = 0.033); patients were most likely to miss doses on Saturdays and Thursdays. Patients missed a total of 11 follow-up visits. During the study, 92 biopsies were performed on 55 patients (intervention group: 32 [17]; control group, 60 [38]). Biopsy-verified rejection was three times more common among controls (13 patients vs. 4; P = 0.054, not significant). Average P-creatinine level was slightly lower in the intervention group than the control group (131 vs. 150 μmol/L, not significant), whereas mean tacrolimus was similar (7.32 vs. 7.22 ng/mL, n.s.). The EMD is associated with high compliance, and there are also indications of a lower rejection rate.

  15. Understanding Medical Students' Experience with Stress and Its Related Constructs: A Focus Group Study from Singapore.

    Science.gov (United States)

    Farquhar, Julia; Lie, Desiree; Chan, Angelique; Ow, Mandy; Vidyarthi, Arpana

    2018-02-01

    In order to protect medical students from burnout and its untoward psychiatric effects, it is imperative to understand their stress, burnout, coping, and resilience experiences. This study aimed to derive collective definitions from the medical student perspective, to identify common themes of students' experiences, and to distinguish pre-clinical and clinical year students' experiences relating to these four constructs. The authors conducted focus groups of medical students in Singapore across 4 years using a semi-structured question guide. Participants shared their understanding, experiences, and the relationships between stress, burnout, coping, and resilience. Coders independently evaluated construct definitions and derived common themes through an iterative process, and compared transcripts of pre-clinical and clinical year students to determine differences in experience over time. Nine focus groups (54 students, 28 females, mean age 24.3) were conducted. Students identified common definitions for each construct. Nine themes emerged within three domains: (1) relating constructs to personal experience, (2) interrelating stress, burnout, coping, and resilience, and (3) understanding the necessity of stress. Compared to clinical students, pre-clinical students reported theory-based rather than reality-based experiences and exam-induced stress, defined constructs using present rather than future situations, and described constructs as independent rather than interrelated. This sample of medical students in Singapore shares a common understanding of stress, burnout, coping, and resilience, but experiences these uniquely. They perceive a positive role for stress. These findings build upon prior literature, suggesting an interrelationship between stress and its related constructs and adding the novel perspective of students from an Asian country.

  16. The role of abdominal compliance, the neglected parameter in critically ill patients - a consensus review of 16. Part 1: definitions and pathophysiology.

    Science.gov (United States)

    Malbrain, Manu L N G; Roberts, Derek J; De Laet, Inneke; De Waele, Jan J; Sugrue, Michael; Schachtrupp, Alexander; Duchesne, Juan; Van Ramshorst, Gabrielle; De Keulenaer, Bart; Kirkpatrick, Andrew W; Ahmadi-Noorbakhsh, Siavash; Mulier, Jan; Ivatury, Rao; Pracca, Francisco; Wise, Robert; Pelosi, Paolo

    2014-01-01

    Over the last few decades, increasing attention has been paid to understanding the pathophysiology, aetiology, prognosis, and treatment of elevated intra-abdominal pressure (IAP) in trauma, surgical, and medical patients. However, there is presently a relatively poor understanding of intra-abdominal volume (IAV) and the relationship between IAV and IAP (i.e. abdominal compliance). Consensus definitions on Cab were discussed during the 5th World Congress on Abdominal Compartment Syndrome and a writing committee was formed to develop this article. During the writing process, a systematic and structured Medline and PubMed search was conducted to identify relevant studies relating to the topic. According to the recently updated consensus definitions of the World Society on Abdominal Compartment Syndrome (WSACS), abdominal compliance (Cab) is defined as a measure of the ease of abdominal expansion, which is determined by the elasticity of the abdominal wall and diaphragm. It should be expressed as the change in IAV per change in IAP (mL [mm Hg]⁻¹). Importantly, Cab is measured differently than IAP and the abdominal wall (and its compliance) is only a part of the total abdominal pressure-volume (PV) relationship. During an increase in IAV, different phases are encountered: the reshaping, stretching, and pressurisation phases. The first part of this review article starts with a comprehensive list of the different definitions related to IAP (at baseline, during respiratory variations, at maximal IAV), IAV (at baseline, additional volume, abdominal workspace, maximal and unadapted volume), and abdominal compliance and elastance (i.e. the relationship between IAV and IAP). An historical background on the pathophysiology related to IAP, IAV and Cab follows this. Measurement of Cab is difficult at the bedside and can only be done in a case of change (removal or addition) in IAV. The Cab is one of the most neglected parameters in critically ill patients, although it plays a

  17. Understanding the psychosocial and physical work environment in a Singapore medical school.

    Science.gov (United States)

    Chan, G C T; Koh, D

    2007-02-01

    This study aims to understand the physical and psychosocial work environment, expectations and the perceived levels of stress encountered of medical students in Singapore. A cross-sectional study employing a self-administered work environment questionnaire was applied over a one-week period to the entire 2003/2004 medical school cohort (1,069 students, response rate 85 percent) from the first to fifth (final) years at the National University of Singapore. 3.3 percent had at least one needlestick injury within the academic year. The majority (especially the clinical students) also had musculoskeletal complaints (neck and back mainly) within the last three months. Using the General Health Questionnaire, it was found that 49.6 percent encountered significant stress and 64.6 percent reported that more than 60 percent of their total life stress was due to medical school. The most important psychosocial stressors were: too much work and difficulty in coping. The clinical students were particularly concerned about being good medical students and doctors. The reasons for choosing Medicine as a career and social health (health, study and sleep habits) were also studied. The health risks of a medical student are primarily psychosocial in nature. The biggest challenges are work demands, maintaining a work-life balance and managing the psychosocial work environment.

  18. Understanding Patients' Process to Use Medical Marijuana: A Southern New Jersey Community Engagement Project.

    Science.gov (United States)

    Crowell, Tara L

    2016-09-01

    Given the necessity to better understand the process patients need to go through in order to seek treatment via medical marijuana, this study investigates this process to better understand this phenomenon. Specifically, Compassion Care Foundation (CCF) and Stockton University worked together to identify a solution to this problem. Specifically, 240 new patients at CCF were asked to complete a 1-page survey regarding various aspects associated with their experience prior to their use of medicinal marijuana-diagnosis, what prompted them to seek treatment, level of satisfaction with specific stages in the process, total length of time the process took, and patient's level of pain. Results reveal numerous patient diagnoses for which medical marijuana is being prescribed; the top 4 most common are intractable skeletal spasticity, chronic and severe pain, multiple sclerosis, and inflammatory bowel disease. Next, results indicate a little over half of the patients were first prompted to seek alternative treatment from their physicians, while the remaining patients indicated that other sources such as written information along with friends, relatives, media, and the Internet persuaded them to seek treatment. These data indicate that a variety of sources play a role in prompting patients to seek alternative treatment and is a critical first step in this process. Additional results posit that once patients began the process of qualifying to receive medical marijuana as treatment, the process seemed more positive even though it takes patients on average almost 6 months to obtain their first treatment after they started the process. Finally, results indicate that patients are reporting a moderately high level of pain prior to treatment. Implication of these results highlights several important elements in the patients' initial steps toward seeking medical marijuana, along with the quality and quantity of the process patients must engage in prior to obtaining treatment. In

  19. Formalizing and appling compliance patterns for business process compliance

    NARCIS (Netherlands)

    Elgammal, A.; Turetken, O.; van den Heuvel, W.; Papazoglou, M.

    2016-01-01

    Today’s enterprises demand a high degree of compliance of business processes to meet diverse regulations and legislations. Several industrial studies have shown that compliance management is a daunting task, and organizations are still struggling and spending billions of dollars annually to ensure

  20. Formalizing and applying compliance patterns for business process compliance

    NARCIS (Netherlands)

    Elgammal, A.F.S.A.; Türetken, O.; van den Heuvel, W.J.A.M.; Papazoglou, M.

    Today’s enterprises demand a high degree of compliance of business processes to meet diverse regulations and legislations. Several industrial studies have shown that compliance management is a daunting task, and organizations are still struggling and spending billions of dollars annually to ensure

  1. Diagnostic information for compliance checking of temporal compliance requirements

    NARCIS (Netherlands)

    Ramezani Taghiabadi, E.; Fahland, D.; Dongen, van B.F.; Aalst, van der W.M.P.; Salinesi, C.; Norrie, M.C.; Pastor, O.

    2013-01-01

    Compliance checking is gaining importance as today’s organizations need to show that operational processes are executed in a controlled manner while satisfying predefined (legal) requirements or service level agreements. Deviations may be costly and expose an organization to severe risks. Compliance

  2. Cure or curse? Ambivalent attitudes towards neuroleptic medication in schizophrenia and non-schizophrenia patients.

    Science.gov (United States)

    Moritz, Steffen; Peters, Maarten J V; Karow, Anne; Deljkovic, Azra; Tonn, Peter; Naber, Dieter

    2009-10-30

    Neuroleptic non-compliance remains a serious challenge for the treatment of psychosis. Non-compliance is predominantly attributed to side effects, lack of illness insight, reduced well-being or poor therapeutic alliance. However, other still neglected factors may also play a role. Further, little is known about whether psychiatric patients without psychosis who are increasingly prescribed neuroleptics differ in terms of medication compliance or about reasons for non-compliance by psychosis patients. As direct questioning is notoriously prone to social desirability biases, we conducted an anonymous survey. After a strict selection process blind to results, 95 psychiatric patients were retained for the final analyses (69 participants with a presumed diagnosis of schizophrenia psychosis, 26 without psychosis). Self-reported neuroleptic non-compliance was more prevalent in psychosis patients than non-psychosis patients. Apart from side effects and illness insight, main reasons for non-compliance in both groups were forgetfulness, distrust in therapist, and no subjective need for treatment. Other notable reasons were stigma and advice of relatives/acquaintances against neuroleptic medication. Gain from illness was a reason for non-compliance in 11-18% of the psychosis patients. Only 9% of all patients reported no side effects and full compliance and at the same time acknowledged that neuroleptics worked well for them. While pills were preferred over depot injections by the majority of patients, depot was judged as an alternative by a substantial subgroup. Although many patients acknowledge the need and benefits of neuroleptic medication, non-compliance was the norm rather than the exception in our samples.

  3. Cure or curse? Ambivalent attitudes towards neuroleptic medication in schizophrenia and non-schizophrenia patients

    Directory of Open Access Journals (Sweden)

    Dieter Naber

    2009-10-01

    Full Text Available Neuroleptic non-compliance remains a serious challenge for the treatment of psychosis. Non-compliance is predominantly attributed to side effects, lack of illness insight, reduced well-being or poor therapeutic alliance. However, other still neglected factors may also play a role. Further, little is known about whether psychiatric patients without psychosis who are increasingly prescribed neuroleptics differ in terms of medication compliance or about reasons for non-compliance by psychosis patients. As direct questioning is notoriously prone to social desirability biases, we conducted an anonymous survey. After a strict selection process blind to results, 95 psychiatric patients were retained for the final analyses (69 participants with a presumed diagnosis of schizophrenia psychosis, 26 without psychosis. Self-reported neuroleptic non-compliance was more prevalent in psychosis patients than non-psychosis patients. Apart from side effects and illness insight, main reasons for non-compliance in both groups were forgetfulness, distrust in therapist, and no subjective need for treatment. Other notable reasons were stigma and advice of relatives/acquaintances against neuroleptic medication. Gain from illness was a reason for non-compliance in 11-18% of the psychosis patients. Only 9% of all patients reported no side effects and full compliance and at the same time acknowledged that neuroleptics worked well for them. While pills were preferred over depot injections by the majority of patients, depot was judged as an alternative by a substantial subgroup. Although many patients acknowledge the need and benefits of neuroleptic medication, non-compliance was the norm rather than the exception in our samples.

  4. Organizational performance and regulatory compliance as measured by clinical pertinence indicators before and after implementation of Anesthesia Information Management System (AIMS).

    Science.gov (United States)

    Choi, Clark K; Saberito, Darlene; Tyagaraj, Changa; Tyagaraj, Kalpana

    2014-01-01

    Previous studies have suggested that electronic medical records (EMR) can lead to a greater reduction of medical errors and better adherence to regulatory compliance than paper medical records (PMR). In order to assess the organizational performance and regulatory compliance, we tracked different clinical pertinence indicators (CPI) in our anesthesia information management system (AIMS) for 5 years. These indicators comprised of the protocols from the Surgical Care Improvement Project (SCIP), elements of performance (EP) from The Joint Commission (TJC), and guidelines from the Centers for Medicare and Medicaid Services (CMS). A comprehensive AIMS was initiated and the CPI were collected from October 5, 2009 to December 31, 2010 (EMR period) and from January 1, 2006 to October 4, 2009 (PMR period). Fourteen CPI were found to be common between the EMR and PMR periods. Based on the statistical analysis of the 14 common CPI, there was a significant increase (p < 0.001) in overall compliance after the introduction of EMR compared to the PMR period. The increase in overall compliance was significantly progressive (p = 0.013) from year to year over 2006 and 2010. Of the 14 CPI, Documentation of a) medication doses, and b) monitoring of postoperative physiological status, mental status, and pain scores showed significant improvement (p < 0.001) during the EMR period compared to the PMR period.

  5. ENA study cites barriers to NPSG compliance.

    Science.gov (United States)

    2009-04-01

    There are many barriers to compliance with the National Patient Safety Goals, as a recent study shows. However, emergency medicine experts say there are several strategies you can adopt to help overcome those barriers. Send the right message to your staff by establishing a culture of shared responsibility for safety. Establish scripts for talking with patients. Standardization will help ensure they are getting the correct information. Put standardized abbreviations on posters in your department, and list them on your medication reconciliation form.

  6. Barriers to and facilitators of compliance with clinic-based cervical cancer screening: population-based cohort study of women aged 23-60 years.

    Science.gov (United States)

    Östensson, Ellinor; Alder, Susanna; Elfström, K Miriam; Sundström, Karin; Zethraeus, Niklas; Arbyn, Marc; Andersson, Sonia

    2015-01-01

    This study aims to identify possible barriers to and facilitators of cervical cancer screening by (a) estimating time and travel costs and other direct non-medical costs incurred in attending clinic-based cervical cancer screening, (b) investigating screening compliance and reasons for noncompliance, (c) determining women's knowledge of human papillomavirus (HPV), its relationship to cervical cancer, and HPV and cervical cancer prevention, and (d) investigating correlates of HPV knowledge and screening compliance. 1510 women attending the clinic-based cervical cancer screening program in Stockholm, Sweden were included. Data on sociodemographic characteristics, time and travel costs and other direct non-medical costs incurred in attending (e.g., indirect cost of time needed for the screening visit, transportation costs, child care costs, etc.), mode(s) of travel, time, distance, companion's attendance, HPV knowledge, and screening compliance were obtained via self-administered questionnaire. Few respondents had low socioeconomic status. Mean total time and travel costs and direct non-medical cost per attendance, including companion (if any) were €55.6. Over half (53%) of the respondents took time off work to attend screening (mean time 147 minutes). A large portion (44%) of the respondents were noncompliant (i.e., did not attend screening within 1 year of the initial invitation), 51% of whom stated difficulties in taking time off work. 64% of all respondents knew that HPV vaccination was available; only 34% knew it was important to continue to attend screening following vaccination. Age, education, and income were the most important correlates of HPV knowledge and compliance; and additional factors associated with compliance were time off work, accompanying companion and HPV knowledge. Time and travel costs and other direct non-medical costs for clinic-based screening can be considerable, may affect the cost-effectiveness of a screening program, and may

  7. Barriers to and facilitators of compliance with clinic-based cervical cancer screening: population-based cohort study of women aged 23-60 years.

    Directory of Open Access Journals (Sweden)

    Ellinor Östensson

    Full Text Available This study aims to identify possible barriers to and facilitators of cervical cancer screening by (a estimating time and travel costs and other direct non-medical costs incurred in attending clinic-based cervical cancer screening, (b investigating screening compliance and reasons for noncompliance, (c determining women's knowledge of human papillomavirus (HPV, its relationship to cervical cancer, and HPV and cervical cancer prevention, and (d investigating correlates of HPV knowledge and screening compliance.1510 women attending the clinic-based cervical cancer screening program in Stockholm, Sweden were included. Data on sociodemographic characteristics, time and travel costs and other direct non-medical costs incurred in attending (e.g., indirect cost of time needed for the screening visit, transportation costs, child care costs, etc., mode(s of travel, time, distance, companion's attendance, HPV knowledge, and screening compliance were obtained via self-administered questionnaire.Few respondents had low socioeconomic status. Mean total time and travel costs and direct non-medical cost per attendance, including companion (if any were €55.6. Over half (53% of the respondents took time off work to attend screening (mean time 147 minutes. A large portion (44% of the respondents were noncompliant (i.e., did not attend screening within 1 year of the initial invitation, 51% of whom stated difficulties in taking time off work. 64% of all respondents knew that HPV vaccination was available; only 34% knew it was important to continue to attend screening following vaccination. Age, education, and income were the most important correlates of HPV knowledge and compliance; and additional factors associated with compliance were time off work, accompanying companion and HPV knowledge.Time and travel costs and other direct non-medical costs for clinic-based screening can be considerable, may affect the cost-effectiveness of a screening program, and may

  8. Use of Electronic Medical Record–Enhanced Checklist and Electronic Dashboard to Decrease CLABSIs

    Science.gov (United States)

    Longhurst, Christopher A.; Wood, Matthew; Cornfield, David N.; Suermondt, Jaap; Sharek, Paul J.; Franzon, Deborah

    2014-01-01

    OBJECTIVES: We hypothesized that a checklist enhanced by the electronic medical record and a unit-wide dashboard would improve compliance with an evidence-based, pediatric-specific catheter care bundle and decrease central line–associated bloodstream infections (CLABSI). METHODS: We performed a cohort study with historical controls that included all patients with a central venous catheter in a 24-bed PICU in an academic children’s hospital. Postintervention CLABSI rates, compliance with bundle elements, and staff perceptions of communication were evaluated and compared with preintervention data. RESULTS: CLABSI rates decreased from 2.6 CLABSIs per 1000 line-days before intervention to 0.7 CLABSIs per 1000 line-days after intervention. Analysis of specific bundle elements demonstrated increased daily documentation of line necessity from 30% to 73% (P < .001), increased compliance with dressing changes from 87% to 90% (P = .003), increased compliance with cap changes from 87% to 93% (P < .001), increased compliance with port needle changes from 69% to 95% (P < .001), but decreased compliance with insertion bundle documentation from 67% to 62% (P = .001). Changes in the care plan were made during review of the electronic medical record checklist on 39% of patient rounds episodes. CONCLUSIONS: Use of an electronic medical record–enhanced CLABSI prevention checklist coupled with a unit-wide real-time display of adherence was associated with increased compliance with evidence-based catheter care and sustained decrease in CLABSI rates. These data underscore the potential for computerized interventions to promote compliance with proven best practices and prevent patient harm. PMID:24567021

  9. Extraterritorial reach of the FCPA: recommendations for U.S. medical device companies with activities in Europe.

    Science.gov (United States)

    Vollebregt, Erik

    2010-01-01

    Traditionally medical devices companies manage business compliance with anti-corruption and anti-fraud rules in a document-oriented way that does not always yield optimal results for the company. As a result, compliance issues are not optimally managed by the companies. Now that medical devices companies become ever more internationally active, they must also take into account the international dimensions of business compliance. This article intends to provide U.S. medical devices companies with activities in Europe with an insight in business compliance risks in the European Union (EU) and the risks related to U.S. statutes that may be applicable to a U.S. company's activities overseas. The article proposes a process-oriented and IT-supported way of structuring an international business compliance program, resulting in increased effectiveness of the program and increased competitiveness and risk management of the company as well as a high degree of acceptance of the procedures by the company's employees.

  10. Estimation of the clinical and economic consequences of non-compliance with antimicrobial treatment of canine skin infections.

    Science.gov (United States)

    Van Vlaenderen, Ilse; Nautrup, Barbara Poulsen; Gasper, Sabina M

    2011-05-01

    The goal of this study was to estimate the health and economic consequences of non-compliance with oral antimicrobial treatment in dogs with superficial pyoderma, wounds or abscesses in the US. A mathematical model (Markov model) which simulated treatment with long-term injectable cefovecin versus oral amoxicillin/clavulanic acid was developed and accounted for the effect of non-compliance on clinical outcomes and mean total treatment costs per patient. Efficacy parameters considered in the model were derived from clinical studies. Treatment failure due to oral antimicrobial treatment non-compliance was approximated from published data at 13.6%. US cost data for 2009 were derived from public sources. When non-compliance was considered as a cause of treatment failure with oral medication, the long-term injectable antibiotic was more effective than oral comparator (162 versus 158 days without clinical signs). Mean total treatment costs were lower with cefovecin (USD 376.74) versus amoxicillin/clavulanic acid (USD 382.34) in dogs of 25 kg; and cefovecin remained cost-saving up to a body weight of 31 kg. In large dogs, cefovecin was more costly; however, total therapy costs were less than 6% greater than with amoxicillin/clavulanic acid. Accordingly the higher drug and administration costs of the long-term injectable antibiotic were totally or substantially offset when non-compliance was considered as reason for treatment failure with oral medication. The model also allowed for the estimation of the impact of various non-compliance scenarios. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. 75 FR 61706 - Request for Public Comments Regarding Small and Medium Enterprises' Understanding of and...

    Science.gov (United States)

    2010-10-06

    ... Public Comments Regarding Small and Medium Enterprises' Understanding of and Compliance With the Export... the public regarding small and medium enterprises' (SMEs) understanding of and compliance with export... report, Small and Medium-Sized Enterprises: Overview of Participation in U.S. Exports (USITC Publication...

  12. Patient's perception, compliance to treatment and health education of antiretroviral therapy among HIV patients at a tertiary healthcare setting

    International Nuclear Information System (INIS)

    Hussain, A.R.; Abbas, S.M.; Reza, T.E

    2013-01-01

    Objective: To illustrate perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy among HIV and AIDS patients. Methods: The cross-sectional survey was carried out at the HIV Treatment Centre, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from September 2009 to February 2010 in which patients were interviewed separately regarding their perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy. All data collected was entered into SPSS version 15.0. The data was re-validated and analysed. Results: One hundred and forty patients were interviewed; there were 99 (70.7%) males.. Of the total, 28 (20%) had no knowledge about the beneficial effects of the therapy, and 45 (32 %) ranked health education services extremely beneficial in understanding the anti-retrovival therapy. Conclusion: While a significant proportion of patients considered ART either somewhat beneficial or beneficial in treating their ailment, they were unclear about the impact of health education provided at the treatment centre and different forms of print media. (author)

  13. Patient's perception, compliance to treatment and health education of antiretroviral therapy among HIV patients at a tertiary healthcare setting.

    Science.gov (United States)

    Hussain, Aleem Raza; Abbas, Syed Muslim; Uzma, Qudsia; Reza, Tahira Ezra

    2013-07-01

    To illustrate perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy among HIV and AIDS patients. The cross-sectional survey was carried out at the HIV Treatment Centre, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from September 2009 to February 2010 in which patients were interviewed separately regarding their perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy. All data collected was entered into SPSS version 15.0. The data was revalidated and analysed. One hundred and forty patients were interviewed; there were 99 (70.7%) males.. Of the total, 28 (20%) had no knowledge about the beneficial effects of the therapy, and 45 (32 %) ranked health education services extremely beneficial in understanding the anti-retrovival therapy. While a significant proportion of patients considered ART either somewhat beneficial or beneficial in treating their ailment, they were unclear about the impact of health education provided at the treatment centre and different forms of print media.

  14. Smoke-free medical students' meetings

    DEFF Research Database (Denmark)

    Brown, Colin; Rudkjøbing, Andreas

    2005-01-01

    Medical students of the world have signalled their commitment to health promotion by prohibiting smoking at the semiannual general assembly meetings of the International Federation of Medical Students' Associations (IFMSA). Although initially adopted in 2000, the smoke-free bylaw took 5 years...... to come into force. This year finally saw compliance with the bylaw on March 1, 2005, at the IFMSA General Assembly in Antalya, Turkey, when medical students who wanted to smoke had to do so outside....

  15. Correlates of Tax Compliance of Small and Medium Size Businesses in Cameroon

    Directory of Open Access Journals (Sweden)

    Oludele Akinloye Akinboade

    2015-12-01

    Full Text Available Taxation provides a predictable and stable flow of revenue to finance development objectives. This is important in a country like Cameroon that has serious challenges with meeting its development objectives. Small and medium enterprises (SMEs are significant for economic growth in the country, contributing as much as about 22 percent of the gross domestic product. SMEs generate taxable incomes. They also collect employment and value added taxes on behalf of the government. Taxation, however, imposes high cost to small businesses. SMEs are less tax compliant in comparison to large businesses. SMEs are considered the ‘hard to tax group from the informal sector.’ As such, the literature suggests that only a fraction of their taxable incomes is reported to tax authorities. Against this background, factors that correlate with tax compliance of 575 small and medium size companies in Cameroon are discussed from a survey of companies in the manufacturing and wholesale sectors. High registration cost and time-consuming processes promote tax non-compliance. The perception that tax system is corrupt discourages registration and filing compliance. When there are too many compliance hurdles, the probability of filing compliance is reduced. However, a fair and static system encourages filing and registration compliance. A clear and consistent tax system promotes filing compliance. Authorities that understand their responsibilities and are willing to respond to enquiries during the registration process promote tax compliance in general.

  16. Student manual, Book 2: Orientation to occupational safety compliance in DOE

    Energy Technology Data Exchange (ETDEWEB)

    Colley, D.L.

    1993-10-01

    This is a student hand-book an Occupational Safety Compliance in DOE. Topics include the following: Electrical; materials handling & storage; inspection responsibilities & procedures; general environmental controls; confined space entry; lockout/tagout; office safety, ergonomics & human factors; medical & first aid, access to records; construction safety; injury/illness reporting system; and accident investigation procedures.

  17. Why do farmers behave as they do? Understanding compliance with rural, agricultural, and food attribute standards

    NARCIS (Netherlands)

    Herzfeld, T.; Jongeneel, R.A.

    2012-01-01

    Agricultural production experiences a shift in underlying institutions during the last years., Importance of private stakeholders like retailers, processors, consumers as well as tax payers is, emerging. Eligibility for single farm payments and marketing of products is linked to compliance with,

  18. Understanding the debate on medical education research: a sociological perspective.

    Science.gov (United States)

    Albert, Mathieu

    2004-10-01

    Since the mid-1990s, a debate has taken place among medical education scholars regarding the forms that research should take and the roles it should play. Editors of major journals in medical education and prominent researchers in the domain have repeatedly addressed the issue and have attempted to define what medical education research should be. The goal of this article is to look at the debate from a sociological perspective and to outline the social factors shaping it. An analysis of the texts published since 1990 addressing the issue shows that the debates can be deconstructed in four topics: epistemology, methodology, the primary purpose of medical education research, and the "quality" of the projects carried out in the domain. However, the debates can also be amalgamated and synthesized using the concept of "field" as developed by sociologist Pierre Bourdieu. A "field" refers to the configuration of power relations among individuals, social groups, or institutions within a domain of activities. Scientific fields are typically structured around a "bipolar" opposition pattern. At one pole stand those individuals who promote greater collaboration with nonscientists as well as research aimed at responding to practical needs. At the opposite pole stand those individuals who aspire to achieve independence of the field from such external constraints. The use of the concept of "field" allows us to understand the debate from a larger perspective and to establish parallels with similar debates in other scientific fields. In doing so, we will have the opportunity to learn from the experience of these other fields and be more reflective about the debate in which we engage.

  19. Can oral fluid cannabinoid testing monitor medication compliance and/or cannabis smoking during oral THC and oromucosal Sativex administration?

    Science.gov (United States)

    Lee, Dayong; Karschner, Erin L; Milman, Garry; Barnes, Allan J; Goodwin, Robert S; Huestis, Marilyn A

    2013-06-01

    We characterize cannabinoid disposition in oral fluid (OF) after dronabinol, synthetic oral Δ(9)-tetrahydrocannabinol (THC), and Sativex, a cannabis-extract oromucosal spray, and evaluate whether smoked cannabis relapse or Sativex compliance can be identified with OF cannabinoid monitoring. 5 and 15 mg synthetic oral THC, low (5.4 mg THC, 5.0 mg cannabidiol (CBD)) and high (16.2 mg THC, 15.0 mg CBD) dose Sativex, and placebo were administered in random order (n=14). Oral fluid specimens were collected for 10.5 h after dosing and analyzed for THC, CBD, cannabinol (CBN), and 11-nor-9-carboxy-THC (THCCOOH). After oral THC, OF THC concentrations decreased over time from baseline, reflecting residual THC excretion from previously self-administered smoked cannabis. CBD and CBN also were rarely detected. After Sativex, THC, CBD and CBN increased greatly, peaking at 0.25-1 h. Median CBD/THC and CBN/THC ratios were 0.82-1.34 and 0.04-0.06, respectively, reflecting cannabinoids' composition in Sativex. THCCOOH/THC ratios within 4.5 h post Sativex were ≤ 1.6 pg/ng, always lower than after oral THC and placebo. THCCOOH/THC ratios increased throughout each dosing session. Lack of measurable THC, CBD and CBN in OF following oral THC, and high OF CBD/THC ratios after Sativex distinguish oral and sublingual drug delivery routes from cannabis smoking. Low THCCOOH/THC ratios suggest recent Sativex and smoked cannabis exposure. These data indicate that OF cannabinoid monitoring can document compliance with Sativex pharmacotherapy, and identify relapse to smoked cannabis during oral THC medication but not Sativex treatment, unless samples were collected shortly after smoking. Published by Elsevier Ireland Ltd.

  20. Compliance with carbapenem guidelines in a university hospital.

    Science.gov (United States)

    Van Hollebeke, M; Chapuis, C; Bernard, S; Foroni, L; Stahl, J P; Bedouch, P; Pavese, P

    2016-03-01

    We aimed to evaluate carbapenem prescription compliance with guidelines for nosocomial and community-acquired infections. We conducted a prospective study over a four-month period at our university hospital. We included all adult and pediatric hospitalized patients who had received at least one dose of carbapenem. Data was collected from patients' medical records (hard copy and computerized data; CristalLink software). Compliance with guidelines was assessed by two infectious disease specialists. Assessment criteria included indication, antibiotic choice, dosage, and treatment duration. We included 152 patients in the study (65.4% of men). Carbapenem prescription was appropriate for 76.3% of prescriptions. The use of carbapenems was considered appropriate for 73.9% of empirical prescriptions and for 77.8% of documented prescriptions. Non-compliance with guidelines was mainly due to prescriptions for community-acquired infections. Antibiotic de-escalation could not be initiated in 40.3% of patients and was only initiated in 51.7% of patients for whom it could be considered. Although the average treatment duration was 7.5 days, 23.7% of patients received carbapenems for more than 10 days. These results highlight the need for a strong carbapenem stewardship program in our hospital. Copyright © 2016. Published by Elsevier SAS.

  1. Adolescents' Compliance-Resistance: Effects of Parents' Compliance Strategy and Gender.

    Science.gov (United States)

    White, Kim D.; And Others

    1989-01-01

    Examined choice of compliance-resisting behaviors among adolescents. Findings from 118 high school students revealed significant differences in resistance strategy the adolescent selected on basis of parent gender, adolescent gender, and compliance-gaining strategy (manipulation, nonnegotiation, emotional appeal, personal rejection, empathic…

  2. Compliance checking of data-aware and resource-aware compliance requirements

    NARCIS (Netherlands)

    Ramezani Taghiabadi, E.; Gromov, V.; Fahland, D.; Aalst, van der W.M.P.; Meersman, R.; Panetto, H.; Dillon, T.; Missikoff, M.; Liu, L.; Pastor, O.; Cuzzocrea, A.; Sllis, T.

    2014-01-01

    Compliance checking is gaining importance as today’s organizations need to show that their business practices are in accordance with predefined (legal) requirements. Current compliance checking techniques are mostly focused on checking the control-flow perspective of business processes. This paper

  3. A systematic review on hand hygiene knowledge and compliance in student nurses.

    Science.gov (United States)

    Labrague, L J; McEnroe-Petitte, D M; van de Mortel, T; Nasirudeen, A M A

    2017-10-27

    Hand hygiene competence is one of the critical outcomes in nursing education. Ensuring nursing students recognize the what, when and how of hand hygiene is critical in the light of the increasing rates of healthcare-associated infections. To systematically appraise and synthesize articles on hand hygiene knowledge and compliance among nursing students. This is a systematic review of scientific articles published from 2006 to 2016. The primary databases used were as follows: PubMed, Embase, Cumulative Index to Nursing & Allied Health Literature, Proquest and PsychINFO. Key search terms utilized were as follows: 'handwashing', 'hand hygiene', 'compliance', 'knowledge', 'practice' and 'nursing students'. Nineteen studies met the review criteria. The findings revealed a low-to-moderate knowledge of and compliance with hand hygiene among nursing students. In addition, there were significantly higher rates of hand hygiene compliance in nursing students when compared to medical students. Relatively few studies attempted to identify predictors of hand hygiene knowledge and compliance. This review demonstrated suboptimal knowledge and compliance to hand hygiene among student nurses. In addition, this review also highlighted the paucity of studies that examined individual and organizational factors, which influence nursing students hand hygiene knowledge and compliance. The findings of this review emphasized the role of nurse educators in enhancing hand hygiene competence in nursing students. Implementation of empirically tested strategies such as utilizing multidimensional interventions, scenario-based hand hygiene simulation activities and hand hygiene education programmes that would enhance nursing students' hand hygiene knowledge and compliance is an asset. Hospital and nursing administrators should ensure continuous support and monitoring to guarantee that hand hygiene programmes are institutionalized in every healthcare setting by every healthcare worker. © 2017

  4. Compliance status

    International Nuclear Information System (INIS)

    Black, D.G.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report summarizes the activities conducted to ensure that the Hanford Site is in compliance with federal environmental protection statutes and related Washington State and local environmental protection regulations and the status of Hanford's compliance with these requirements. Environmental permits required under the environmental protection regulations are discussed under the applicable statute

  5. Sustained Reduction of Ventilator-Associated Pneumonia Rates Using Real-Time Course Correction With a Ventilator Bundle Compliance Dashboard.

    Science.gov (United States)

    Talbot, Thomas R; Carr, Devin; Parmley, C Lee; Martin, Barbara J; Gray, Barbara; Ambrose, Anna; Starmer, Jack

    2015-11-01

    The effectiveness of practice bundles on reducing ventilator-associated pneumonia (VAP) has been questioned. To implement a comprehensive program that included a real-time bundle compliance dashboard to improve compliance and reduce ventilator-associated complications. DESIGN Before-and-after quasi-experimental study with interrupted time-series analysis. SETTING Academic medical center. In 2007 a comprehensive institutional ventilator bundle program was developed. To assess bundle compliance and stimulate instant course correction of noncompliant parameters, a real-time computerized dashboard was developed. Program impact in 6 adult intensive care units (ICUs) was assessed. Bundle compliance was noted as an overall cumulative bundle adherence assessment, reflecting the percentage of time all elements were concurrently in compliance for all patients. The VAP rate in all ICUs combined decreased from 19.5 to 9.2 VAPs per 1,000 ventilator-days following program implementation (Pdashboard was associated with significant sustained decreases in VAP rates and an increase in bundle compliance among adult ICU patients.

  6. Understanding the value of mixed methods research: the Children’s Safety Initiative-Emergency Medical Services

    Science.gov (United States)

    Hansen, Matthew; O’Brien, Kerth; Meckler, Garth; Chang, Anna Marie; Guise, Jeanne-Marie

    2016-01-01

    Mixed methods research has significant potential to broaden the scope of emergency care and specifically emergency medical services investigation. Mixed methods studies involve the coordinated use of qualitative and quantitative research approaches to gain a fuller understanding of practice. By combining what is learnt from multiple methods, these approaches can help to characterise complex healthcare systems, identify the mechanisms of complex problems such as medical errors and understand aspects of human interaction such as communication, behaviour and team performance. Mixed methods approaches may be particularly useful for out-of-hospital care researchers because care is provided in complex systems where equipment, interpersonal interactions, societal norms, environment and other factors influence patient outcomes. The overall objectives of this paper are to (1) introduce the fundamental concepts and approaches of mixed methods research and (2) describe the interrelation and complementary features of the quantitative and qualitative components of mixed methods studies using specific examples from the Children’s Safety Initiative-Emergency Medical Services (CSI-EMS), a large National Institutes of Health-funded research project conducted in the USA. PMID:26949970

  7. [Assessment of compliance for oral medicines with MMSE, Mini-Mental State Examination, in hospitalized elderly patients].

    Science.gov (United States)

    Miura, Masatomo; Kakei, Masafumi; Iwasawa, Saaya; Morii, Tsukasa; Miura, Takeshi; Sasaki, Hiroshi; Satoh, Takehiro; Fujita, Hiroki; Narita, Takuma; Shirakawa, Hideko; Yamada, Yuichiro; Suzuki, Toshio

    2007-10-01

    The minimental state examination (MMSE) is a widely used, standardized method to assess cognitive function including movement-related disorders with high reliability. We studied the relationship between MMSE scores and the ability to take oral medications correctly (ingestion compliance) in 70 elderly inpatients (mean age 71.3+/-7.0 years). Patients with abnormal glucose tolerance as determined by an HbA(1c) level of 5.8% or greater including diabetes showed a trend of lower MMSE scores compared with patients with normal glucose tolerance, and the scores were negatively correlated with HbA1c, age, and systolic blood pressure (P<0.05). Self-management in taking oral medications was very difficult in 4 patients whose MMSE scores were 21 points or less. Thus ingestion supervisions by nurses were required in these patients. Furthermore, 9 of 12 noncompliant patients had MMSE scores ranging from 22 to 26 points. We instructed these patients to take medications in a one-dose package as a useful tool to improve compliance. The MMSE score was 27 or higher in 44 of 54 compliant patients, and 10 patients had scores ranging from 21 to 26. The sensitivity and specificity for noncompliance at an MMSE score cut-off point of 26 were 75.0% and 81.5%, respectively. In conclusion, it is necessary to coordinate ingestion methods matched to each patient according to their abilities to comply with medication schedules. They should be preevaluated with the MMSE to improve ingestion compliance. The MMSE is a recommended test in hospitalized elderly patients for the assessment of the ability to take medications safely.

  8. Post Implementation of Goods and Services Tax (GST in Malaysia: Tax Agents’ Perceptions on Clients’ Compliance Behaviour and Tax Agents’ Roles in Promoting Compliance

    Directory of Open Access Journals (Sweden)

    Muhammad Izlawanie

    2017-01-01

    Full Text Available The Malaysian government introduced the Goods and Services Tax (GST starting from 1 April 2015 to enhance the revenue collections and mitigate the transfer pricing manipulation. Tax agents play a significant role to help businesses to comply with GST law and regulations. After one year of GST implementation, it is vital to understand tax agents’ perceptions on clients’ compliance behaviour and tax agents’ roles in influencing compliance. A total of 30 registered tax agents completed a survey questionnaire. The analysis shows that tax agents devote their time to provide advice to their clients on meeting their GST requirements, and recording and reporting of GST transactions. Tax agents assert that clients pass on their GST responsibilities to tax agents to some extent. Tax agents also perceive that clients’ compliance level is low because clients occasionally submit GST03 after the deadline, compromise the accuracy of GST03 in order to get it done on time and intentionally make errors in their records. In terms of tax agents’ role in promoting compliance, the tax agents strongly agree that it is important for them to act as trusted advisors for their clients. After one year of GST implementation, this is the first study that explores tax agents’ perceptions on clients’ compliance and tax agents’ roles in promoting compliance. The findings benefit the Royal Malaysian Customs Department (RMCD in assisting tax agents and the public for future compliance. Similar study should be adopted by countries that have recently implemented GST (for example, India and it should be conducted to other GST players (i.e. taxpayers and RMCD officers on annual basis to analyse the behavioural trends and identify weaknesses in GST administration.

  9. Patients’ attention to and understanding of adverse drug reaction warnings

    Directory of Open Access Journals (Sweden)

    Tresa Muir McNeal

    2010-12-01

    Full Text Available Tresa Muir McNeal1, Colleen Y Colbert1, Christian Cable1, Curtis R Mirkes1, June G Lubowinski2, John D Myers11Department of Medicine, Texas A&M University System HSC College of Medicine, Scott & White Healthcare, Temple, TX, USA; 2RD Haynes Medical Library, Scott & White Healthcare, Temple, TX, USAIntroduction: Medications are critical to the management of patient conditions, and they can have significant effects on the success or failure of medical interventions. Patient perceptions of drug warnings play an important role in medication compliance and ultimately disease management. Several factors may affect patients’ understanding of drug warnings and drug labeling, including health literacy and interactions with physicians and pharmacists.Purpose: The purpose of this article is to provide a review of the literature related to patient perceptions of drug warnings and drug labeling. Descriptive articles and studies regarding patient perceptions and knowledge of adverse drug reaction warnings were reviewed.Methods: The following databases were utilized to search the literature related to patient perceptions of drug warnings: PubMed, Academic Search Premiere, CINAHL, Medline, Psych Info, Business Source Complete, Alternative Healthwatch, Health Source (both Nursing/Academic and Consumer additions, JSTOR, and Master File Premiere. For the purpose of this review, any peer-reviewed article was eligible. Exclusionary criteria included: articles published in languages other than English, articles/studies on patient perceptions of vaccines and chemotherapy, and articles related to perceptions of medications administered in the inpatient setting. Forty-six articles were included in the review.Results: Health literacy has been shown to have a major impact on patients’ ability to understand potential adverse reactions and instructions on correct dosing of medications. Direct communication with physicians and pharmacists is one of the most important and

  10. Influence of Housing Wall Compliance on Shock Absorbers in the Context of Vehicle Dynamics

    Science.gov (United States)

    Pulvirenti, G.; Faria, C.

    2017-10-01

    Shock absorbers play a key role in vehicle dynamics. Researchers have spent significant effort in order to understand phenomena associated with this component, but there are still several issues to address, in part because new technology development and design trends continually lead to new challenges, among which weight reduction is crucial. For shock absorbers, weight reduction is related to the use of new materials (e.g. composite) or new design paradigms (e.g. more complex geometry, wall thickness, etc.). All of them are directly linked to wall compliance values higher than the actual ones. The present article proposes a first analysis of the phenomena introduced by a high wall compliance, through a modelling approach and various simulations in order to understand the vehicle behaviour changes. It is shown that high values of wall compliance lead to increased hysteresis in the force-velocity curve. However, comfort, handling and ride performances are not significantly affected by this designing parameter.

  11. Factors influencing patient compliance with therapeutic regimens in chronic heart failure: A critical incident technique analysis.

    Science.gov (United States)

    Strömberg, A; Broström, A; Dahlström, U; Fridlund, B

    1999-01-01

    The aim of this study was to identify factors influencing compliance with prescribed treatment in patients with chronic heart failure. A qualitative design with a critical incident technique was used. Incidents were collected through interviews with 25 patients with heart failure strategically selected from a primary health care clinic, a medical ward, and a specialist clinic. Two hundred sixty critical incidents were identified in the interviews and 2 main areas emerged in the analysis: inward factors and outward factors. The inward factors described how compliance was influenced by the personality of the patient, the disease, and the treatment. The outward factors described how compliance was influenced by social activities, social relationships, and health care professionals. By identifying the inward and outward factors influencing patients with chronic heart failure, health care professionals can assess whether intervention is needed to increase compliance.

  12. Compliance status

    Energy Technology Data Exchange (ETDEWEB)

    Black, D.G.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the activities conducted to ensure that the Hanford Site is in compliance with federal environmental protection statutes and related Washington State and local environmental protection regulations and the status of Hanford`s compliance with these requirements. Environmental permits required under the environmental protection regulations are discussed under the applicable statute.

  13. Performing compliance

    DEFF Research Database (Denmark)

    Wimmelmann, Camilla Lawaetz

    2017-01-01

    the local policy workers front-staged some practices in the implementation process and back-staged others. The local policy workers deliberately performed ‘guideline compliance’ by using information control and impression management techniques. The findings suggest that local guideline compliance should...... be regarded as a staged performance in which deliberate techniques are used to produce and manage certain impressions of compliance....

  14. Cure or curse? Ambivalent attitudes towards neuroleptic medication in schizophrenia and non-schizophrenia patients

    OpenAIRE

    Dieter Naber; Peter Tonn; Azra Deljkovic; Anne Karow; Maarten J.V. Peters; Steffen Moritz

    2009-01-01

    Neuroleptic non-compliance remains a serious challenge for the treatment of psychosis. Non-compliance is predominantly attributed to side effects, lack of illness insight, reduced well-being or poor therapeutic alliance. However, other still neglected factors may also play a role. Further, little is known about whether psychiatric patients without psychosis who are increasingly prescribed neuroleptics differ in terms of medication compliance or about reasons for non-compliance by psychosis pa...

  15. Student manual, Book 2: Orientation to occupational safety compliance in DOE

    International Nuclear Information System (INIS)

    Colley, D.L.

    1993-01-01

    This is a student hand-book an Occupational Safety Compliance in DOE. Topics include the following: Electrical; materials handling ampersand storage; inspection responsibilities ampersand procedures; general environmental controls; confined space entry; lockout/tagout; office safety, ergonomics ampersand human factors; medical ampersand first aid, access to records; construction safety; injury/illness reporting system; and accident investigation procedures

  16. Randomized, double blind comparison of brand and generic antibiotic suspensions: II. A study of taste and compliance in children.

    Science.gov (United States)

    El-Chaar, G M; Mardy, G; Wehlou, K; Rubin, L G

    1996-01-01

    The taste of oral liquid medications influences compliance in children. Generic preparations are prescribed to reduce cost and may taste worse than brand name products. This was a prospective, randomized, double blind, crossover trial of the differences in taste and compliance between brand and generic antibiotic suspensions in children 3 to 14 years of age. Verbal and visual assessment methods were used to assess taste, and compliance was measured by the amount of drug returned after use. Ten children in each of the cephalexin and erythromycin-sulfisoxazole groups did not report that the brand and generic formulations tasted differently. Fifteen children thought that brand trimethoprim-sulfamethoxazole tasted better than the generic preparation. Brand name oral liquid antibiotics do not necessarily taste better than their generic counterparts. Despite preference for the taste of brand trimethoprim-sulfamethoxazole, all of the children in this study were compliant with both brand and generic medications.

  17. Understanding the value of mixed methods research: the Children's Safety Initiative-Emergency Medical Services.

    Science.gov (United States)

    Hansen, Matthew; O'Brien, Kerth; Meckler, Garth; Chang, Anna Marie; Guise, Jeanne-Marie

    2016-07-01

    Mixed methods research has significant potential to broaden the scope of emergency care and specifically emergency medical services investigation. Mixed methods studies involve the coordinated use of qualitative and quantitative research approaches to gain a fuller understanding of practice. By combining what is learnt from multiple methods, these approaches can help to characterise complex healthcare systems, identify the mechanisms of complex problems such as medical errors and understand aspects of human interaction such as communication, behaviour and team performance. Mixed methods approaches may be particularly useful for out-of-hospital care researchers because care is provided in complex systems where equipment, interpersonal interactions, societal norms, environment and other factors influence patient outcomes. The overall objectives of this paper are to (1) introduce the fundamental concepts and approaches of mixed methods research and (2) describe the interrelation and complementary features of the quantitative and qualitative components of mixed methods studies using specific examples from the Children's Safety Initiative-Emergency Medical Services (CSI-EMS), a large National Institutes of Health-funded research project conducted in the USA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  18. 76 FR 66074 - Small Entity Compliance Guide: Required Warnings for Cigarette Packages and Advertisements...

    Science.gov (United States)

    2011-10-25

    ...The Food and Drug Administration (FDA) is announcing the availability of a guidance for industry entitled ``Required Warnings for Cigarette Packages and Advertisements--Small Entity Compliance Guide'' for a final rule published in the Federal Register on June 22, 2011. This small entity compliance guide (SECG) is intended to set forth in plain language the requirements of the regulation and to help small businesses understand and comply with the regulation.

  19. Diabetes Support Groups Improve Patient’s Compliance and Control Blood Glucose Levels

    Directory of Open Access Journals (Sweden)

    Zamrotul Izzah

    2013-09-01

    Full Text Available Providing information is not enough to improve diabetic patient’s compliance and achieve goals of therapy. Patient’s good awareness as well as emotional and social supports from family and community may play an important role to improve their compliance and clinical outcomes. Therefore, diabetes support groups were developed and each support group consisted of two pharmacists, two nurses, diabetic patients and their family members. A total of 70 type 2 diabetic patient’s were enrolled and randomized into support group 1 and support group 2. Patients in the group 1 received information leaflets only, while patient in the group 2 received pharmacist counselling and information leaflets at each meeting. Patient’s awareness of diabetes and compliance with medications were assessed by a short questionnaire at baseline and final follow-up. Blood glucose and cholesterol levels were also evaluated in both groups. At the end of study, the overall patient’s awareness and compliance improved by 61.5%. The random and fasting blood glucose levels decreased over than 30% in the group 2 and around 14% in the group 1. This study reveals that collaboration between health care professionals and community in the diabetes support group might help diabetic patients to increase their knowledge and compliance with the diabetes therapy as well as glycaemic control.

  20. Patient Safety in Medication Nomenclature: Orthographic and Semantic Properties of International Nonproprietary Names.

    Directory of Open Access Journals (Sweden)

    Rachel Bryan

    Full Text Available Confusion between look-alike and sound-alike (LASA medication names (such as mercaptamine and mercaptopurine accounts for up to one in four medication errors, threatening patient safety. Error reduction strategies include computerized physician order entry interventions, and 'Tall Man' lettering. The purpose of this study is to explore the medication name designation process, to elucidate properties that may prime the risk of confusion.We analysed the formal and semantic properties of 7,987 International Non-proprietary Names (INNs, in relation to naming guidelines of the World Health Organization (WHO INN programme, and have identified potential for errors. We explored: their linguistic properties, the underlying taxonomy of stems to indicate pharmacological interrelationships, and similarities between INNs. We used Microsoft Excel for analysis, including calculation of Levenshtein edit distance (LED. Compliance with WHO naming guidelines was inconsistent. Since the 1970s there has been a trend towards compliance in formal properties, such as word length, but longer names published in the 1950s and 1960s are still in use. The stems used to show pharmacological interrelationships are not spelled consistently and the guidelines do not impose an unequivocal order on them, making the meanings of INNs difficult to understand. Pairs of INNs sharing a stem (appropriately or not often have high levels of similarity (<5 LED, and thus have greater potential for confusion.We have revealed a tension between WHO guidelines stipulating use of stems to denote meaning, and the aim of reducing similarities in nomenclature. To mitigate this tension and reduce the risk of confusion, the stem system should be made clear and well ordered, so as to avoid compounding the risk of confusion at the clinical level. The interplay between the different WHO INN naming principles should be further examined, to better understand their implications for the problem of LASA

  1. THE ROLE OF BROADCASTING AGENCY TO BUILD THE LEGAL COMPLIANCE OF SOCIETY

    Directory of Open Access Journals (Sweden)

    Lilik Rukitasari

    2016-06-01

    Full Text Available Abstract Broadcasting has become part of peoples’ lives needs for information, entertainment and education. Broadcasting agency as mass communication media play a role to shape the behavior of political, social, and economic in every society, in order to establish the public legal compliance through broadcasting activities that are counseling and law clarification, it takes effective communication media so that the target is expected to be achieved through increased the quality broadcast programs and attractive containing understanding and knowledge about the law will be able to increase publics’ consciousness and legal compliance. This study using sociological-juridical approach by analyzing the empirical data in order to understand the social and legal responsibilities and functions of broadcasting as a mass communication media is effective in disseminating the law and the formation of values, the result of study drawn through the broadcast media were able to create a culture norms, it means the function of media is not only as a transmitter of information to disseminate the law to the public but also it can have the effect of influencing and encouraging the change of behavior towards the law-abiding. Keywords: Broadcasting Agency, Law Compliance, Society

  2. An automated hand hygiene training system improves hand hygiene technique but not compliance.

    Science.gov (United States)

    Kwok, Yen Lee Angela; Callard, Michelle; McLaws, Mary-Louise

    2015-08-01

    The hand hygiene technique that the World Health Organization recommends for cleansing hands with soap and water or alcohol-based handrub consists of 7 poses. We used an automated training system to improve clinicians' hand hygiene technique and test whether this affected hospitalwide hand hygiene compliance. Seven hundred eighty-nine medical and nursing staff volunteered to participate in a self-directed training session using the automated training system. The proportion of successful first attempts was reported for each of the 7 poses. Hand hygiene compliance was collected according to the national requirement and rates for 2011-2014 were used to determine the effect of the training system on compliance. The highest pass rate was for pose 1 (palm to palm) at 77% (606 out of 789), whereas pose 6 (clean thumbs) had the lowest pass rate at 27% (216 out of 789). One hundred volunteers provided feedback to 8 items related to satisfaction with the automated training system and most (86%) expressed a high degree of satisfaction and all reported that this method was time-efficient. There was no significant change in compliance rates after the introduction of the automated training system. Observed compliance during the posttraining period declined but increased to 82% in response to other strategies. Technology for training clinicians in the 7 poses played an important education role but did not affect compliance rates. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  3. Environmental Compliance Guide

    International Nuclear Information System (INIS)

    1981-02-01

    The Guide is intended to assist Department of Energy personnel by providing information on the NEPA process, the processes of other environmental statutes that bear on the NEPA process, the timing relationships between the NEPA process and these other processes, as well as timing relationships between the NEPA process and the development process for policies, programs, and projects. This information should be helpful not only in formulating environmental compliance plans but also in achieving compliance with NEPA and various other environmental statutes. The Guide is divided into three parts with related appendices: Part I provides guidance for developing environmental compliance plans for DOE actions; Part II is devoted to NEPA with detailed flowcharts depicting the compliance procedures required by CEQ regulations and Department of Energy NEPA Guidelines; and Part III contains a series of flowcharts for other Federal environmental requirements that may apply to DOE projects

  4. Environmental Compliance Guide

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-02-01

    The Guide is intended to assist Department of Energy personnel by providing information on the NEPA process, the processes of other environmental statutes that bear on the NEPA process, the timing relationships between the NEPA process and these other processes, as well as timing relationships between the NEPA process and the development process for policies, programs, and projects. This information should be helpful not only in formulating environmental compliance plans but also in achieving compliance with NEPA and various other environmental statutes. The Guide is divided into three parts with related appendices: Part I provides guidance for developing environmental compliance plans for DOE actions; Part II is devoted to NEPA with detailed flowcharts depicting the compliance procedures required by CEQ regulations and Department of Energy NEPA Guidelines; and Part III contains a series of flowcharts for other Federal environmental requirements that may apply to DOE projects.

  5. Effects of Long Duration Spaceflight on Venous and Arterial Compliance in Astronants

    Science.gov (United States)

    Platts, Steven; Ribeiro, L. Christine

    2014-01-01

    1. Project Overview Visual impairment and intracranial pressure (VIIP) is a spaceflight-associated medical condition affecting at least a third of American astronauts who have flown International Space Station (ISS) missions. VIIP is defined primarily by visual acuity deficits and anatomical changes to eye structures. In some astronauts, eye-related changes do not revert back to the preflight state upon return to Earth. Our team will study some of the possible causes for this syndrome. This will be achieved by reviewing previous astronaut data for factors that may predispose astronauts to higher rates of developing this syndrome or greater severity of symptoms. Additionally, we will conduct 3 separate experiments that will characterize vessels in the head and neck and measure the effects of the experimental conditions on ocular structures and function. 2. Technical Summary The primary objective of this study is to determine whether vascular compliance is altered by spaceflight and whether such adaptations are related to the incidence of the VIIP. In particular, we will measure ocular parameters and vascular compliance in vessels of the head and neck in astronauts who have no spaceflight experience (Ground), in astronauts before, during, and after spaceflight (Flight), and in bed rest subjects with conditions similar to spaceflight (Bed Rest). Additionally, we will analyze astronaut data from the Lifetime Surveillance of Astronaut Health (LSAH) archives to determine which factors might be predictive of the development of VIIP (Data Mining). The project will be conducted in four separate, but related parts. Hypothesis The central hypothesis of this proposal is that exposure to the spaceflight environment aboard the ISS may lead to development of the VIIP syndrome (increased intracranial pressure and impaired visual acuity) and that this may be related to alterations in venous and/or arterial compliance in the head and neck. Specific Aims 1. To determine whether

  6. State and Alternative Fuel Provider Fleets Alternative Compliance; U.S. Department of Energy (DOE), Energy Efficiency & Renewable Energy (EERE)

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-08-01

    The final rule of the Energy Policy Act of 2005 and its associated regulations enable covered state and alternative fuel provider fleets to obtain waivers from the alternative fuel vehicle (AFV)-acquisition requirements of Standard Compliance. Under Alternative Compliance, covered fleets instead meet a petroleum-use reduction requirement. This guidance document is designed to help fleets better understand the Alternative Compliance option and successfully complete the waiver application process.

  7. Monitoring compliance with standards of care for chronic diseases using healthcare administrative databases in Italy: Strengths and limitations.

    Directory of Open Access Journals (Sweden)

    Rosa Gini

    Full Text Available A recent comprehensive report on healthcare quality in Italy published by the Organization of Economic Co-operation and Development (OECD recommended that regular monitoring of quality of primary care by means of compliance with standards of care for chronic diseases is performed. A previous ecological study demonstrated that compliance with standards of care could be reliably estimated on regional level using administrative databases. This study compares estimates based on administrative data with estimates based on GP records for the same persons, to understand whether ecological fallacy played a role in the results of the previous study.We compared estimates of compliance with diagnostic and therapeutic standards of care for type 2 diabetes (T2DM, hypertension and ischaemic heart disease (IHD from administrative data (IAD with estimates from medical records (MR for the same persons registered with 24 GP's in 2012. Data were linked at an individual level.32,688 persons entered the study, 12,673 having at least one of the three diseases according to at least one data source. Patients not detected by IAD were many, for all three conditions: adding MR increased the number of cases of T2DM, hypertension, and IHD by +40%, +42%, and +104%, respectively. IAD had imperfect sensitivity in detecting population compliance with therapies (adding MR increased the estimate, from +11.5% for statins to +14.7% for antithrombotics, and, more substantially, with diagnostic recommendations (adding MR increased the estimate, from +23.7% in glycated hemoglobin tests, to +50.5% in electrocardiogram. Patients not detected by IAD were less compliant with respect to those that IAD correctly identified (from -4.8 percentage points in proportion of IHD patients compliant with a yearly glycated hemoglobin test, to -40.1 points in the proportion of T2DM patients compliant with the same recommendation. IAD overestimated indicators of compliance with therapeutic standards

  8. Choices that increase compliance

    International Nuclear Information System (INIS)

    Edwards, P.R.

    1991-01-01

    A compliance model is developed and tested using a survey of corporate officials and the regulatory arena of equal employment opportunity. Findings support the economic model of compliance in its conclusion that probability of detection and probable level of sanctions influence compliance decisions. Results also indicate that adjustments to the model that account for bounded rationality are valid. The key outcome, however, is that although all types of investigations play some role in enhancing compliance, those that stress sanctions and thus severity rather than certainty of detection may have the greatest positive influence on compliance. Enforcement programs attempting to operate simply as investigators of small-scale complaints will have less success than those with different types of investigations or a balanced type of single investigation. The results also suggest a more complex cognitive process on the part of regulated individuals than initially theorized. 34 refs., 3 tabs

  9. A Study on Corporate Security Awareness and Compliance Behavior Intent

    Science.gov (United States)

    Clark, Christine Y.

    2013-01-01

    Understanding the drivers to encourage employees' security compliance behavior is increasingly important in today's highly networked environment to protect computer and information assets of the company. The traditional approach for corporations to implement technology-based controls, to prevent security breaches is no longer sufficient.…

  10. 'Consumers are patients!' shared decision-making and treatment non-compliance as business opportunity.

    Science.gov (United States)

    Applbaum, Kalman

    2009-03-01

    This article describes an aspect of the progressive insertion of commercial interests into the relationship between patients and their clinicians, with particular reference to psychiatry. Treatment noncompliance, a long-standing problem for healthcare professionals, has lately drawn the attention of the pharmaceutical and allied industries as a site at which to improve return on investment (ROI). Newly founded corporate ;compliance departments' and specialized consultancies that regard noncompliance as a form of marketing failure are seeking to rectify it with reinvigorated models and strategies. This intervention stands to impact patients' experience of illness as well as the participation of those formally (physicians, case managers, etc.) and informally (family, friends, etc.) involved in treatment. My analysis draws upon observation at compliance conferences to demonstrate the contrasting models of patient empowerment underlying the marketing vs. medical approaches. I propose a research agenda for measuring the effects of industry compliance programs.

  11. Educational value of pocket-sized ultrasound devices to improve understanding of ultrasound examination principles and sonographic anatomy for medical student.

    Directory of Open Access Journals (Sweden)

    Eun Young Kim

    Full Text Available Medical students must understand the principles of ultrasonography (US, because US examinations are an important component of patient care in clinical practice. Pocket-sized ultrasound devices have the benefits of accessibility and ease of use. The primary objective of the present study was to evaluate the educational value of these devices in terms of improving medical student interest and understanding of US and sonographic anatomy.We added a US training program comprised of a self-study learning module and a hands-on training session to a two-week block curriculum of medical imaging for first year medical students (n = 40. Multiple pocket-sized US devices were used on a small-group basis during a single afternoon. Students were asked to complete a questionnaire before and after the US training session; these two questionnaires contained 6 and 10 questions, respectively, which were rated by students using a five-point Likert scale. In addition, understanding of sonographic anatomy was tested before and after the training program.Forty students completed the two questionnaires and the anatomy-related tests. Students found the program educationally valuable (4.37 ± 0.54 of 5 and reported that US practice was useful for improving their understanding of the principles of US examinations (4.23 ± 0.66 of 5 and sonographic anatomy (4.40 ± 0.55 of 5. Overall confidence at performing US examinations and understanding of sonographic anatomy were significantly increased after US training (increased overall confidence score, 1.87 ± 0.91 and improvement in sonographic anatomy score, 6.55 ± 1.55, p values < 0.001.US training using pocket-sized ultrasound devices was found to be educationally valuable for medical students in terms of improving understanding of US principles and familiarizing students with sonographic anatomy.

  12. Real-world evaluation of compliance and preference in Alzheimer’s disease treatment: an observational study in Taiwan 

    Directory of Open Access Journals (Sweden)

    Lai TH

    2016-03-01

    Full Text Available Tzu-Hsien Lai,1,2,* Wen-Fu Wang,3,* Bak-Sau Yip,4 Yu-Wan Yang,5 Giia-Sheun Peng,6 Shih-Jei Tsai,7,8 Yi-Chu Liao,9 Ming-Chyi Pai10,111Section of Neurology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, 2Department of Neurology, National Yang-Ming University School of Medicine, Taipei, 3Department of Neurology, Changhua Christian Hospital, Changhua, 4Department of Neurology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, 5Department of Neurology, China Medical University Hospital, Taichung, 6Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, 7Department of Neurology, Chung Shan Medical University Hospital, Taichung, 8School of Medicine, Chung Shan Medical University, Taichung, 9Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, 10Division of Behavioral Neurology, Department of Neurology, 11Alzheimer’s Disease Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan *These authors contributed equally to this workPurpose: Among the medications approved for Alzheimer’s disease (AD, rivastigmine is the only one available as transdermal patch. The aim of this study was to evaluate compliance and caregivers’ preference with oral and transdermal (rivastigmine monotherapy in patients with mild-to-moderate AD from Taiwan.Methods: Real-world Evaluation of Compliance And Preference in Alzheimer’s disease treatment (RECAP in Taiwan was a prospective, noninterventional, observational study with a 24-week (±8 weeks observational period for each participant. Eligible patients were grouped into one of the two treatment cohorts based on the baseline AD therapy: oral (donepezil, galantamine, rivastigmine, or memantine or transdermal (rivastigmine patch. The primary end points were caregiver preference and caregiver assessment of patients’ compliance to

  13. Informed consent and stimulant medication: adolescents' and parents' ability to understand information about benefits and risks of stimulant medication for the treatment of attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Schachter, Debbie; Tharmalingam, Sukirtha; Kleinman, Irwin

    2011-04-01

    This study of informed consent examines understanding of information needed to consent to stimulant treatment for attention-deficit/hyperactivity disorder (ADHD). The understanding of adolescents with ADHD, their parents, control adolescents, and their parents is compared. Fifty-eight ADHD and 64 control adolescents between the ages of 12 and 16 and their parents were studied. Baseline understanding of information was determined. Subjects received information relevant to informed consent for stimulation medication and afterward were evaluated on their recall understanding and their final understanding. Knowledge was increased after the information session for all subjects. There was no significant difference between unadjusted baseline, recall, and final knowledge of control adolescents and parents. Although unadjusted baseline, recall, and final knowledge of ADHD adolescents is significantly less than that of parents, 78% of ADHD adolescents had final understanding scores within 2 standard deviations of parents' scores. After controlling for baseline understanding and cognitive variables, there was no significant difference between understanding of ADHD adolescents and ADHD parents, whereas control adolescents understanding scores were higher than that of their parents. Understanding was highly associated with mathematics achievement in all groups. The majority of adolescents with ADHD, both with and without a history of stimulant medication treatment, have understanding that is similar to their parents and their inclusion in the informed consent process should be encouraged. Extra care should be afforded to those adolescents with low numeracy or literacy to ensure their understanding.

  14. Particularly compliance violations in patients with diabetes mellitus of 2nd type

    Directory of Open Access Journals (Sweden)

    V. V. Chugunov

    2017-04-01

    Full Text Available Aim: to investigate and establish the specific complains violations in patients with diabetes mellitus (DM of 2nd type. Materials and methods: 543 patients with DM of 2nd type were examined; the disease duration ranged from 2 to 27 years, average – (14.58 ± 1.82 years. Research methods: clinical-anamnestic, clinical-psychopathological, psycho diagnostic, statistical. Research results. We found that compliance to therapy in patients with DM of 2nd type was broken in 90.49 % of cases. We highlighted three options for compliance violations to DM therapy of 2nd type: dismedication (to 68.14 %, disdiet (88.40 % and disexercise (90.49 %. The sub-variants of dismedication compliance violations to DM therapy of 2nd type was hyper-curation type (8.29 %, which was developed according to surplus of appointments execution and hypo-curation type (59.85 %, which was developed according to deficiency of appointments execution. Among them it was possible to distinguish a third – mixed version (7.37 %, which brings together episodes of the surplus and the deficit of medical drugs usage. The sub-options of disdiet option of compliance violations was hyper-curation type (1.66 %, which manifested itself in pathologically excessive rejection of food and hypo-curation type (86.74 %, which manifested itself in a disregard for the restrictions in the diet. Disexercise variant of compliance violations was possible to divide into hyper-curation type (4,24 %, manifested in excessive physical activity and, in its turn, had three subtypes – inceptional (1.66 %, sub-hyper-curation (1.10 % and procurationis (1.47 %, and hypo-curation type of compliance violations (87.48 %, which manifested itself in a disregard of physical exertion. Dominance of disdiet and disexercise compliance violations among patients with DM of 2nd type (χ2 = 117.258, p < 0.01, dismedication option among patients of all hyper-curation types of compliance violations with DM of 2nd type (χ2 = 26

  15. THE APPLICATION OF THE CROSS COMPLIANCE IN DIRECT PAYMENTS TO FARMERS

    Directory of Open Access Journals (Sweden)

    Constantin DARIE

    2014-12-01

    Full Text Available This paper is a summary of the study on the optimization of cross compliance in direct payments to farmers in Romania by assessing the situation on the enforcement of cross compliance schemes and measures to support farmers during 2007-2013 and find the best implementation model for the next period. This has been used data and information from IACS database, audit reports and statistical reports on cross, managed by APIA. The analysis shows the existence of a large number of standards for good agricultural and environmental condition (GAEC and the statutory management requirements (SMR in continuous revision, difficult to understand by land surveyors and farmers have to comply. This led to a large number of nonconformities and sanctions to reduce payments to certain standards/requirements (approx. 23,029 cases of non-compliance, i.e. 25.86% of the farmers control and penalties totaling approx. 1,412,690 € for period analyzed, with a negative impact on the use of EU funds for agriculture. In response to the matters referred propose simplification of cross compliance, reducing the number of standards and mandatory requirements for farmers (from 13 standards GAEC and 18 requirements SMR currently to 7 standards GAEC and 13 requirements SMR in the new implementation an effective system of management and control, and an action plan on informing farmers on cross compliance.

  16. Deadline Compliance Status Reports

    Data.gov (United States)

    Department of Housing and Urban Development — These monthly Deadline Compliance Status Reports assist Participating Jurisdictions and HUD Field Offices in monitoring compliance with the 2-year commitment and...

  17. FISCAL CULTURE - AS KEY ELEMENTS OF ENSURING TAX COMPLIANCE IN DEVELOPING COUNTRIES (BASED ON THE REPUBLIC OF MOLDOVA EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Diana CRICLIVAIA

    2013-01-01

    Full Text Available Tax avoidance and tax evasion have considerably consumed the ink and papers of academic research because taxation is an issue that has been relevant in the last 6000 years of human history and will continue to be relevant in the future. Questions about tax compliance are as old as taxes themselves and will remain an area of discovery as long as taxes exist. To understand the impact of a tax system, it is important to know who complies with the tax law as well as who does not. In this paper I discuss several key factors that seem to be important for understanding tax compliance in Republic of Moldova: factors of tax evasion and avoidance, consequences and methods for ensuring tax compliance.

  18. Knowledge about pandemic influenza and compliance with containment measures among Australians.

    Science.gov (United States)

    Eastwood, Keith; Durrheim, David; Francis, J Lynn; d'Espaignet, Edouard Tursan; Duncan, Sarah; Islam, Fakhrul; Speare, Rick

    2009-08-01

    To examine the level of stated compliance with public health pandemic influenza control measures and explore factors influencing cooperation for pandemic influenza control in Australia. A computer-assisted telephone interview survey was conducted by professional interviewers to collect information on the Australian public's knowledge of pandemic influenza and willingness to comply with public health control measures. The sample was randomly selected using an electronic database and printed telephone directories to ensure sample representativeness from all Australian states and territories. After we described pandemic influenza to the respondents to ensure they understood the significance of the issue, the questions on compliance were repeated and changes in responses were analysed with McNemar's test for paired data Only 23% of the 1166 respondents demonstrated a clear understanding of the term 'pandemic influenza'. Of those interviewed, 94.1% reported being willing to comply with home quarantine; 94.2%, to avoid public events; and 90.7%, to postpone social gatherings. After we explained the meaning of 'pandemic' to interviewees, stated compliance increased significantly (to 97.5%, 98.3% and 97.2% respectively). Those who reported being unfamiliar with the term 'pandemic influenza,' male respondents and employed people not able to work from home were less willing to comply. In Australia, should the threat arise, compliance with containment measures against pandemic influenza is likely to be high, yet it could be further enhanced through a public education programme conveying just a few key messages. A basic understanding of pandemic influenza is associated with stated willingness to comply with containment measures. Investing now in promoting measures to prepare for a pandemic or other health emergency will have considerable value.

  19. Newborn follow-up after discharge from the maternity unit: Compliance with national guidelines.

    Science.gov (United States)

    Roisné, J; Delattre, M; Rousseau, S; Bourlet, A; Charkaluk, M-L

    2018-02-01

    In the context of shorter hospital stays in maternity units, in 2014 the French health authorities issued guidelines for newborn follow-up after discharge from maternity units. A medical visit is recommended between the 6th and 10th day of life, as are home visits from midwives. This study was designed to evaluate compliance with these guidelines. The study was observational, prospective, multicenter, and was conducted in March and April 2015 in three maternity units in northern France that participate in the Baby Friendly Hospital Initiative (BFHI). Follow-up practices (medical visit between the 6th and 10th day, home visits from a midwife) and demographic, social, and medical data were recorded during the stay in the maternity unit, and through a phone interview 1 month later, in singleton term-born infants. The study population included 108 mother-infant pairs. The recommended medical visit was effectively performed by a physician between the 6th and 10th day of life for 20 newborns (19%) (95% CI: [11; 26]). During the 1st month, at least one home visit from a midwife was recorded for 96 mother-infant pairs (89%). The only factor positively correlated with a medical visit between the 6th and 10th day was the mother's choice, made early during the hospital stay and independently of the real length of stay, for early discharge from the maternity unit. Compliance with national guidelines was poor for the recommended medical visit between the 6th and 10th day of life. Information needs to be improved. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. Compliance. Regulatory policy P-211

    International Nuclear Information System (INIS)

    2001-05-01

    This regulatory policy describes the basic principles and directives for establishing and conducting the Canadian Nuclear Safety Commission (CNSC) Compliance Program. The program is aimed at securing compliance by regulated persons with regulatory requirements made under the Nuclear Safety and Control Act ('the Act'). The policy applies to persons who are regulated by the CNSC through the Act, regulations and licences, as well as by decisions and orders made under the Act. The policy applies to officers and employees of the CNSC, and its authorized representatives or agents, who are involved in developing and carrying out compliance activities. Compliance, in the context of this policy, means conformity by regulated persons with the legally binding requirements of the Act, and the CNSC regulations, licences, decisions, and orders made under the Act. Compliance activities are CNSC measures of promotion, verification and enforcement aimed at securing compliance by regulated person with the applicable legally binding requirements. (author)

  1. Revisiting the generalized scaling law for adhesion: role of compliance and extension to progressive failure.

    Science.gov (United States)

    Mojdehi, Ahmad R; Holmes, Douglas P; Dillard, David A

    2017-10-25

    A generalized scaling law, based on the classical fracture mechanics approach, is developed to predict the bond strength of adhesive systems. The proposed scaling relationship depends on the rate of change of debond area with compliance, rather than the ratio of area to compliance. This distinction can have a profound impact on the expected bond strength of systems, particularly when the failure mechanism changes or the compliance of the load train increases. Based on the classical fracture mechanics approach for rate-independent materials, the load train compliance should not affect the force capacity of the adhesive system, whereas when the area to compliance ratio is used as the scaling parameter, it directly influences the bond strength, making it necessary to distinguish compliance contributions. To verify the scaling relationship, single lap shear tests were performed for a given pressure sensitive adhesive (PSA) tape specimens with different bond areas, number of backing layers, and load train compliance. The shear lag model was used to derive closed-form relationships for the system compliance and its derivative with respect to the debond area. Digital image correlation (DIC) is implemented to verify the non-uniform shear stress distribution obtained from the shear lag model in a lap shear geometry. The results obtained from this approach could lead to a better understanding of the relationship between bond strength and the geometry and mechanical properties of adhesive systems.

  2. understanding medical ethics in a contemporary society

    African Journals Online (AJOL)

    drclement

    these basic principles will go a long way in reducing the ... medical practitioner must therefore be prepared at all ... physician accepts to see a patient, he must define in his ... tells the nurse who is doing daily ..... International Journal of Medical ...

  3. Identifying and Predicting Profiles of Medical Noncompliance: Pediatric Caregivers' Antibiotic Stewardship.

    Science.gov (United States)

    Smith, Rachel A; Kim, Youllee; M'Ikanatha, Nkuchia M

    2018-05-14

    Sometimes compliance with medical recommendations is problematic. We investigated pediatric caregivers' (N = 606) patterns of noncompliance with antibiotic stewardship based on the obstacle hypothesis. We tested predictors of noncompliance framed by the obstacle hypothesis, dissonance theory, and psychological reactance. The results revealed four profiles of caregivers' stewardship: one marked by compliance (Stewards) and three marked by types of noncompliance (Stockers, Persuaders, and Dissenters). The covariate analysis showed that, although psychological reactance predicted being noncompliant, it was types of obstacles and discrepant experiences that predicted caregivers' patterns of noncompliance with antibiotic stewardship. Campaign planning often focuses on identifying the belief most associated with the targeted outcome, such as compliance. Noncompliance research, however, points out that persuaders may be successful to the extent to which they anticipate obstacles to compliance and address them in their influence attempts. A shift from medical noncompliance to patient engagement also affords an opportunity to consider how some recommendations create obstacles for others and to find positive ways to embrace conflicting needs, tensions, and reasons for refusal in order to promote collective goals.

  4. [Accreditation of medical laboratories].

    Science.gov (United States)

    Horváth, Andrea Rita; Ring, Rózsa; Fehér, Miklós; Mikó, Tivadar

    2003-07-27

    In Hungary, the National Accreditation Body was established by government in 1995 as an independent, non-profit organization, and has exclusive rights to accredit, amongst others, medical laboratories. The National Accreditation Body has two Specialist Advisory Committees in the health care sector. One is the Health Care Specialist Advisory Committee that accredits certifying bodies, which deal with certification of hospitals. The other Specialist Advisory Committee for Medical Laboratories is directly involved in accrediting medical laboratory services of health care institutions. The Specialist Advisory Committee for Medical Laboratories is a multidisciplinary peer review group of experts from all disciplines of in vitro diagnostics, i.e. laboratory medicine, microbiology, histopathology and blood banking. At present, the only published International Standard applicable to laboratories is ISO/IEC 17025:1999. Work has been in progress on the official approval of the new ISO 15189 standard, specific to medical laboratories. Until the official approval of the International Standard ISO 15189, as accreditation standard, the Hungarian National Accreditation Body has decided to progress with accreditation by formulating explanatory notes to the ISO/IEC 17025:1999 document, using ISO/FDIS 15189:2000, the European EC4 criteria and CPA (UK) Ltd accreditation standards as guidelines. This harmonized guideline provides 'explanations' that facilitate the application of ISO/IEC 17025:1999 to medical laboratories, and can be used as a checklist for the verification of compliance during the onsite assessment of the laboratory. The harmonized guideline adapted the process model of ISO 9001:2000 to rearrange the main clauses of ISO/IEC 17025:1999. This rearrangement does not only make the guideline compliant with ISO 9001:2000 but also improves understanding for those working in medical laboratories, and facilitates the training and education of laboratory staff. With the

  5. TU-C-18C-01: Medical Physics 1.0 to 2.0: Introduction and Panel Discussion

    International Nuclear Information System (INIS)

    Samei, E; Pfeiffer, D; Frey, G; Krupinski, E; Pizzutiello, R; Carson, P; Mahesh, M; Hangiandreou, N; Jordan, D; Dixon, R

    2014-01-01

    Medical Physics 2.0, a new frontier in clinical imaging physics: Diagnostic imaging has always been a technological highlight of modern medicine. Imaging systems, with their ever-expanding advancement in terms of technology and application, increasingly require skilled expertise to understand the delicacy of their operation, monitor their performance, design their effective use, and ensure their overall quality and safety, scientifically and in quantitative terms. Physicists can play a crucial role in that process. But that role has largely remained a severely untapped resource. Many imaging centers fail to appreciate this potential, with medical physics groups either nonexistent or highly understaffed and their services poorly integrated into the patient care process. As a field, we have yet to define and enact how the clinical physicist can engage as an active, effective, and integral member of the clinical team, and how the services that she/he provides can be financially accounted for. Physicists do and will always contribute to research and development. However, their indispensible contribution to clinical imaging operations is something that has not been adequately established. That, in conjunction with new realities of healthcare practice, indicates a growing need to establish an updated approach to clinical medical imaging physics. This presentation aims to describe a vision as how clinical imaging physics can expand beyond traditional insular models of inspection and acceptance testing, oriented toward compliance, towards team-based models of operational engagement addressing topics such as new non-classical challenges of new technologies, quantitative imaging, and operational optimization. The Medical Physics 2.0 paradigm extends clinical medical physics from isolated characterization of inherent properties of the equipment to effective use of the equipment and to retrospective evaluation of clinical performance. This is an existential transition of the

  6. TU-C-18C-01: Medical Physics 1.0 to 2.0: Introduction and Panel Discussion

    Energy Technology Data Exchange (ETDEWEB)

    Samei, E [Duke University Medical Center, Durham, NC (United States); Pfeiffer, D [Boulder Community Hospital, Boulder, CO (United States); Frey, G [The American Board of Radiology, Charleston, SC (United States); Krupinski, E [University Arizona, Tucson, AZ (United States); Pizzutiello, R [Upstate Medical Physics, Victor, NY (United States); Carson, P [The University of Michigan Health System, Ann Arbor, MI (United States); Mahesh, M [Johns Hopkins Univ, Baltimore, MD (United States); Hangiandreou, N [Mayo Clinic, Rochester, MN (United States); Jordan, D [University Hospitals Case Medical Center, Cleveland, OH (United States); Dixon, R

    2014-06-15

    Medical Physics 2.0, a new frontier in clinical imaging physics: Diagnostic imaging has always been a technological highlight of modern medicine. Imaging systems, with their ever-expanding advancement in terms of technology and application, increasingly require skilled expertise to understand the delicacy of their operation, monitor their performance, design their effective use, and ensure their overall quality and safety, scientifically and in quantitative terms. Physicists can play a crucial role in that process. But that role has largely remained a severely untapped resource. Many imaging centers fail to appreciate this potential, with medical physics groups either nonexistent or highly understaffed and their services poorly integrated into the patient care process. As a field, we have yet to define and enact how the clinical physicist can engage as an active, effective, and integral member of the clinical team, and how the services that she/he provides can be financially accounted for. Physicists do and will always contribute to research and development. However, their indispensible contribution to clinical imaging operations is something that has not been adequately established. That, in conjunction with new realities of healthcare practice, indicates a growing need to establish an updated approach to clinical medical imaging physics. This presentation aims to describe a vision as how clinical imaging physics can expand beyond traditional insular models of inspection and acceptance testing, oriented toward compliance, towards team-based models of operational engagement addressing topics such as new non-classical challenges of new technologies, quantitative imaging, and operational optimization. The Medical Physics 2.0 paradigm extends clinical medical physics from isolated characterization of inherent properties of the equipment to effective use of the equipment and to retrospective evaluation of clinical performance. This is an existential transition of the

  7. A quasi-experimental study to determine the effects of a multifaceted educational intervention on hand hygiene compliance in a radiography unit.

    Science.gov (United States)

    O'Donoghue, Margaret; Ng, Suk-Hing; Suen, Lorna Kp; Boost, Maureen

    2016-01-01

    Whilst numerous studies have investigated nurses' compliance with hand hygiene and use of alcohol-based hand rub (ABHR), limited attention has been paid to these issues in allied health staff. Reports have linked infections to breaches in infection control in the radiography unit (RU). With advances in medical imaging, a higher proportion of patients come into contact with RU staff increasing the need for good hand hygiene compliance. This study aimed to evaluate effectiveness on compliance of an intervention to improve awareness of hand hygiene in the RU of a district hospital. A quasi-experimental study design including questionnaires assessing knowledge and attitudes of hand hygiene and direct observation of participants was used to evaluate an educational programme on hand hygiene of the RU of a large district hospital. All healthcare workers (HCW), comprising 76 radiographers, 17 nurses, and nine healthcare assistants (HCA), agreed to participate in the study. Of these, 85 completed the initial and 76 the post-test anonymous questionnaire. The hand hygiene compliance of all 102 HCW was observed over a 3-week period prior to and after the intervention. The 2-month intervention consisted of talks on hand hygiene and benefits of ABHR, provision of visual aids, wall-mounted ABHR dispensers, and personal bottles of ABHR. Before the intervention, overall hand hygiene compliance was low (28.9 %). Post-intervention, compliance with hand hygiene increased to 51.4 %. This improvement was significant for radiographers and HCA. Additionally, knowledge and attitudes improved in particular, understanding that ABHR can largely replace handwashing and there is a need to perform hand hygiene after environmental contact. The increased use of ABHR allowed HCW to feel they had enough time to perform hand hygiene. The educational intervention led to increased awareness of hand hygiene opportunities and better acceptance of ABHR use. The reduced time needed to perform hand

  8. A quasi-experimental study to determine the effects of a multifaceted educational intervention on hand hygiene compliance in a radiography unit

    Directory of Open Access Journals (Sweden)

    Margaret O’Donoghue

    2016-10-01

    Full Text Available Abstract Background Whilst numerous studies have investigated nurses’ compliance with hand hygiene and use of alcohol-based hand rub (ABHR, limited attention has been paid to these issues in allied health staff. Reports have linked infections to breaches in infection control in the radiography unit (RU. With advances in medical imaging, a higher proportion of patients come into contact with RU staff increasing the need for good hand hygiene compliance. This study aimed to evaluate effectiveness on compliance of an intervention to improve awareness of hand hygiene in the RU of a district hospital. Methods A quasi-experimental study design including questionnaires assessing knowledge and attitudes of hand hygiene and direct observation of participants was used to evaluate an educational programme on hand hygiene of the RU of a large district hospital. All healthcare workers (HCW, comprising 76 radiographers, 17 nurses, and nine healthcare assistants (HCA, agreed to participate in the study. Of these, 85 completed the initial and 76 the post-test anonymous questionnaire. The hand hygiene compliance of all 102 HCW was observed over a 3-week period prior to and after the intervention. The 2-month intervention consisted of talks on hand hygiene and benefits of ABHR, provision of visual aids, wall-mounted ABHR dispensers, and personal bottles of ABHR. Results Before the intervention, overall hand hygiene compliance was low (28.9 %. Post-intervention, compliance with hand hygiene increased to 51.4 %. This improvement was significant for radiographers and HCA. Additionally, knowledge and attitudes improved in particular, understanding that ABHR can largely replace handwashing and there is a need to perform hand hygiene after environmental contact. The increased use of ABHR allowed HCW to feel they had enough time to perform hand hygiene. Conclusions The educational intervention led to increased awareness of hand hygiene opportunities and better

  9. 12 CFR 1710.19 - Compliance and risk management programs; compliance with other laws.

    Science.gov (United States)

    2010-01-01

    ... OVERSIGHT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SAFETY AND SOUNDNESS CORPORATE GOVERNANCE Corporate Practices and Procedures § 1710.19 Compliance and risk management programs; compliance with other laws. (a...

  10. Self-medication in three Orange Free State communities

    African Journals Online (AJOL)

    lates of non-compliance were explored, but self- medication was not found to be a substitute for formal medical care. S Air Med J 1993; 83: 345·346. Medicines. None. 1-3 types ... availability and accessibility of professional health care;. (iv) the perceived health .... tent manner in which cultural differences, education, health ...

  11. The impact of cost recovery on electric utilities' Clean Air Act compliance strategies

    International Nuclear Information System (INIS)

    Bensinger, D.L.

    1993-01-01

    By 1995, over 200 electric power plant units in twenty one states must comply with Phase I of the acid rain requirements in Title IV of the 1990 Clean Air Act Amendments (CAAA). By the year 2000, an additional 2200 units must comply with the Title IV. Compliance costs are expected to necessitate significant electricity rate increases. In order to recover their compliance costs, utilities must file rate increase requests with state public utility commissions (PUC's), and undergo a rate proceeding involving public heatings. Because of the magnitude of cost and the complexity of compliance options, including interaction with Titles I and III of the CAAA, extensive PUC reviews of compliance strategies are likely. These reviews could become as adversarial as the nuclear prudence reviews of the 1980's. A lack of understanding of air pollution and the CAA by much of the general public and the flexibility of compliance options creates an environment conducive to adverse public reaction to the cost of complying with the Clean Air Act. Public attitudes toward pollution control technologies will be greatly affected by these hearings, and the early plant hearings will shape the utility rate making process under the Clean Air Act. Inadequate cost recovery due to constrained compliance strategies or adverse hearings could significantly inhibit industry willingness to invest in certain control technologies or advanced combustion technologies. There are already signs that Clean Air Act compliance will be the prudence issue of the 1990's for utilities, even where state statutes mandate particular compliance approaches. Specific actions should be undertaken now by the utility industry to improve the probability of sound cost recovery decisions, preserve compliance options, including multimedia strategies, and avoid the social- and cost-acceptance problems of nuclear power

  12. Georgia Compliance Review Self-Study FY 01.

    Science.gov (United States)

    Georgia State Dept. of Education, Atlanta.

    Intended for evaluation of local compliance with special education federal and state legal requirements, this compliance review document includes both the compliance requirements and the criteria by which compliance is determined during the onsite compliance review of Georgia local school systems and state-operated programs. Each legal requirement…

  13. Compliance with removable orthodontic appliances.

    Science.gov (United States)

    Shah, Nirmal

    2017-12-22

    Data sourcesMedline via OVID, PubMed, Cochrane Central Register of Controlled Trials, Web of Science Core Collection, LILACS and BBO databases. Unpublished clinical trials accessed using ClinicalTrials.gov, National Research Register, ProQuest Dissertation and Thesis database.Study selectionTwo authors searched studies from inception until May 2016 without language restrictions. Quantitative and qualitative studies incorporating objective data on compliance with removable appliances, barriers to appliance wear compliance, and interventions to improve compliance were included.Data extraction and synthesisQuality of research was assessed using the Cochrane Collaboration's risk of bias tool, the risk of bias in non-randomised studies of interventions (ROBINS-I), and the mixed methods appraisal tool. Statistical heterogeneity was investigated by examining a graphic display of the estimated compliance levels in conjunction with 95% confidence intervals and quantified using the I-squared statistic. A weighted estimate of objective compliance levels for different appliances in relation to stipulated wear and self-reported levels was also calculated. Risk of publication bias was assessed using funnel plots. Meta-regression was undertaken to assess the relative effects of appliance type on compliance levels.ResultsTwenty-four studies met the inclusion criteria. Of these, 11 were included in the quantitative synthesis. The mean duration of objectively measured wear was considerably lower than stipulated wear time amongst all appliances. Headgear had the greatest discrepancy (5.81 hours, 95% confidence interval, 4.98, 6.64). Self-reported wear time was consistently higher than objectively measured wear time amongst all appliances. Headgear had the greatest discrepancy (5.02 hours, 95% confidence interval, 3.64, 6.40). Two studies found an increase in compliance with headgear and Hawley retainers when patients were aware of monitoring. Five studies found younger age groups to

  14. Case based learning: a method for better understanding of biochemistry in medical students.

    Science.gov (United States)

    Nair, Sandhya Pillai; Shah, Trushna; Seth, Shruti; Pandit, Niraj; Shah, G V

    2013-08-01

    Health professionals need to develop analytic and diagnostic thinking skills and not just a mere accumulation of large amount of facts. Hence, Case Based Learning (CBL) has been used in the medical curriculum for this reason, so that the students are exposed to the real medical problems, which helps them in develop analysing abilities. This also helps them in interpreting and solving the problems and in the course of doing this, they develop interest. In addition to didactic lectures, CBL was used as a learning method. This study was conducted in the Department of Biochemistry, S.B.K.S.M.I and R.C, Sumandeep Vidyapeeth ,Piparia, Gujarat, India. A group of 100 students were selected and they were divided into two groups as the control group and the study group. A total of 50 students were introduced to case based learning, which formed the study group and 50 students who attended didactic lectures formed the control group. A very significant improvement (pmedical curriculum for a better understanding of Biochemistry among the medical students.

  15. Multiple Drivers of Local (Non- Compliance in Community-Based Marine Resource Management: Case Studies from the South Pacific

    Directory of Open Access Journals (Sweden)

    Janne R. Rohe

    2017-05-01

    Full Text Available The outcomes of marine conservation and related management interventions depend to a large extent on people's compliance with these rule systems. In the South Pacific, community-based marine resource management (CBMRM has gained wide recognition as a strategy for the sustainable management of marine resources. In current practice, CBMRM initiatives often build upon customary forms of marine governance, integrating scientific advice and management principles in collaboration with external partners. However, diverse socio-economic developments as well as limited legal mandates can challenge these approaches. Compliance with and effective (legally-backed enforcement of local management strategies constitute a growing challenge for communities—often resulting in considerable impact on the success or failure of CBMRM. Marine management arrangements are highly dynamic over time, and similarly compliance with rule systems tends to change depending on context. Understanding the factors contributing to (non- compliance in a given setting is key to the design and function of adaptive management approaches. Yet, few empirical studies have looked in depth into the dynamics around local (non- compliance with local marine tenure rules under the transforming management arrangements. Using two case studies from Solomon Islands and Fiji, we investigate what drives local (non- compliance with CBMRM and what hinders or supports its effective enforcement. The case studies reveal that non-compliance is mainly driven by: (1 diminishing perceived legitimacy of local rules and rule-makers; (2 increased incentives to break rules due to market access and/ or lack of alternative income; and (3 relatively weak enforcement of local rules (i.e., low perceptions of risk from sanctions for rule-breaking. These drivers do not stand alone but can act together and add up to impair effective management. We further analyze how enforcement of CBMRM is challenged through a range of

  16. 14 CFR 26.49 - Compliance plan.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Compliance plan. 26.49 Section 26.49... Data for Repairs and Alterations § 26.49 Compliance plan. (a) Compliance plan. Except for applicants... January 11, 2008, each person identified in §§ 26.43, 26.45, and 26.47, must submit a compliance plan...

  17. Real-life compliance and persistence among users of subcutaneous and sublingual allergen immunotherapy.

    Science.gov (United States)

    Kiel, Menno A; Röder, Esther; Gerth van Wijk, Roy; Al, Maiwenn J; Hop, Wim C J; Rutten-van Mölken, Maureen P M H

    2013-08-01

    Subcutaneous allergen immunotherapy (SCIT) and sublingual allergen immunotherapy (SLIT) are safe and effective treatments of allergic rhinitis, but high levels of compliance and persistence are crucial to achieving the desired clinical effects. Our objective was to assess levels and predictors of compliance and persistence among grass pollen, tree pollen, and house dust mite immunotherapy users in real life and to estimate the costs of premature discontinuation. We performed a retrospective analysis of a community pharmacy database from The Netherlands containing data from 6486 patients starting immunotherapy for 1 or more of the allergens of interest between 1994 and 2009. Two thousand seven hundred ninety-six patients received SCIT, and 3690 received SLIT. Time to treatment discontinuation was analyzed and included Cox proportional hazard models with time-dependent covariates, where appropriate. Overall, only 18% of users reached the minimally required duration of treatment of 3 years (SCIT, 23%; SLIT, 7%). Median durations for SCIT and SLIT users were 1.7 and 0.6 years, respectively (P < .001). Other independent predictors of premature discontinuation were prescriber, with patients of general practitioners demonstrating longer persistence than those of allergologists and other medical specialists; single-allergen immunotherapy, lower socioeconomic status; and younger age. Of the persistent patients, 56% were never late in picking up their medication from the pharmacy. Direct medication costs per nonpersistent patient discontinuing in the third year of treatment were €3800, an amount that was largely misspent. Real-life persistence is better in SCIT users than in SLIT users, although it is low overall. There is an urgent need for further identification of potential barriers and measures that will enhance persistence and compliance. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  18. Mother Nature versus human nature: public compliance with evacuation and quarantine.

    Science.gov (United States)

    Manuell, Mary-Elise; Cukor, Jeffrey

    2011-04-01

    Effectively controlling the spread of contagious illnesses has become a critical focus of disaster planning. It is likely that quarantine will be a key part of the overall public health strategy utilised during a pandemic, an act of bioterrorism or other emergencies involving contagious agents. While the United States lacks recent experience of large-scale quarantines, it has considerable accumulated experience of large-scale evacuations. Risk perception, life circumstance, work-related issues, and the opinions of influential family, friends and credible public spokespersons all play a role in determining compliance with an evacuation order. Although the comparison is not reported elsewhere to our knowledge, this review of the principal factors affecting compliance with evacuations demonstrates many similarities with those likely to occur during a quarantine. Accurate identification and understanding of barriers to compliance allows for improved planning to protect the public more effectively. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

  19. Gaming of performance measurement in health care: parallels with tax compliance.

    Science.gov (United States)

    Mears, Alex; Webley, Paul

    2010-10-01

    Gaming of performance measurement in health care distorts performance, making it appear better than it is. This can conceal potentially hazardous practice and endanger patients and staff. Research has investigated and categorized this behaviour but as yet has offered little in the way of potential solutions as the drivers are still not well understood. Studies of the psychology of tax behaviour, specifically tax avoidance and evasion, reveal some insights into what the underlying causes are. Looking at health care and tax compliance, seven similarities in response can be detected: negative view of those subject to it; not salient except for specific classes of people; general understanding of the need versus resentment of actuality; cognitive dissonance; moral versus legal grey areas; two levels of objective non-compliance; and four categories of subjective behaviour and attitude. We suggest a model of reaction and compliance for gaming and offer some suggestions as to how this phenomenon might be minimized.

  20. A comparative study of hand hygiene and alcohol-based hand rub use among Irish nursing and medical students.

    Science.gov (United States)

    Kingston, Liz M; O'Connell, Nuala H; Dunne, Colum P

    2018-04-01

    In Ireland, the setting for this study, the national prevalence rate of health care-associated infection (HCAI) in acute-care facilities is 5.2%. Hand hygiene and in particular hand rubbing using alcohol-based hand rub (ABHR) is highly efficacious in preventing HCAI transmission. Yet, compliance among healthcare professionals is sub-optimal. Less is known about the practices of nursing and medical students and no study comparing practices among these groups in Ireland was found. Hence, the aim of this study was to provide insight into the current hand hygiene and hand rubbing practices of nursing and medical students in Ireland and, by doing so, contribute to the broader understanding of this topic. This observational study employed a cross-sectional, self-reported design. An electronically administered questionnaire was sent to all nursing and medical students from one university. Data were analysed using appropriate software. The response rate was 37% (323/872). Higher compliance with the World Health Organisation 'my five moments for hand hygiene' model was reported among nursing students (NS) than medical students (MS), with scope for improvement in both disciplines identified. Hand hygiene compliance was highest after body fluid exposure (99.5% NS, 91% MS) and lowest after touching a patient's surroundings (61.5% NS, 57.5% MS). Attitudes towards hand rubbing were largely positive in both disciplines. 16% of NS were not aware of the clinical contraindications to ABHR use, compared to 45% of MS. 9% of NS did not know when to use soap and water and when to use ABHR, compared to 36% of MS. In contrast, more medical students (46%) than nursing students (22%) were routinely using alcohol-based hand rub for decontamination of hands as recommended. Results suggest scope to review current hand hygiene curricula focusing on the knowledge gaps, the practice deficits and the barriers to ABHR usage identified. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. THE COMPLIANCE CHRONIC RENAL FAILURE PATIENT ON RESTRICTIONS LIQUIDS IN HEMODIALYSIS THERAPY

    Directory of Open Access Journals (Sweden)

    Endang Sri P Ningsih

    2017-04-01

    Full Text Available Introduction: Nonadherence is a rampant problem among patients undergoing dialysis and can impact multiple aspects of patient care, including medications, and treatment regimens as well as dietary and fluid restriction. The purpose of this descriptive correlative research, on hemodyalysa patient with chronic renal failure was to know the influencing factors of compliance patient to fluid restriction. Method: This study used descriptive correlative design, Data was analysed by using distibution frequency and chi square for analysys relation between variable. Result: The result revealed there were nor significant statistic difference at p > 0.05 between age, gender, education level, frequency of hemodyalysa and health education from nurse to compliance patient to fluid restriction (p = 0.647; p = 0.717; p = 0.345; p = 0.774; p = 0.273. Discussion: Level of patient adherence to therapy not influenced by demographi factor but by the quality of interaction health workers and other factors. This study recommended for further analysis of the factors that influence the level of compliance of the patient as psychological factors (belieft , motivation, socio-economic, and social support.

  2. Explaining G20 and BRICS Compliance

    Directory of Open Access Journals (Sweden)

    Marina Larionova

    2016-11-01

    Full Text Available This article explores the internal and external factors influencing the compliance performance of the Group of 20 (G20 and the BRICS. The authors start with an overview of the G20 and BRICS compliance patterns using comparative data onthe number of commitments made by the two institutions, the level of institutional compliance, and distribution of commitments and compliance across issue areas. G20 compliance is traced since the leaders’ first 2008 summit in Washington. The BRICS compliance performance record includes data since the third stand alone summit in Sanya in 2011.The study then takes stock of compliance catalysts embedded in the summits’ discourse: priority placements, numerical targets, timelines, self-accountability pledges and mandates to implement and/or monitor implementation. The authors review trends in the use of catalysts in different years and issue areas and identify commonalities and differences.The analysis then turns to external causes of compliance and focuses on demand for collective actions and members’ collective power to respond and deliver on their pledges. Here the study explores whether the self-accountability mechanisms created by the institutions in response to the demand for effectiveness and legitimacy facilitate compliance.The article concludes by highlighting catalysts, causes of compliance and their combinations with the greatest power to encourage implementation, explaining trends in G20 and BRICS compliance performance. The data sets on G20 and BRICS differ in terms of scale. The G20 data set contains 1,511 commitments of which 114 have been monitored, and the BRICS data set contains 231 commitments of which 23 have been monitored.

  3. Motivation for Compliance with Environmental Regulation

    DEFF Research Database (Denmark)

    Winter, Søren; May, Peter J.

    2001-01-01

    A combination of calculated, normative, and social motivations as well as awareness of rules and capacity to comply are thought to foster compliance with regulations. Hypotheses about these factors were tested with data concerning Danish farmers’ compliance with agro-environmental regulations....... Three key findings emerge: that farmers’ awareness of rules plays a critical role; that normative and social motivations are as influential as calculated motivations in enhancing compliance; and that inspectors’ enforcement style affects compliance differently from that posited in much of the literature...... compliance with social and environmental regulations....

  4. Compliance with air quality regulations

    International Nuclear Information System (INIS)

    Steen, D.V.; Tackett, D.L.

    1990-01-01

    Due to the probable passage of Clean Air Act Amendments in 1990, electric utilities throughout the United States are faced with numerous choices to comply with the new acid rain regulations, expected in 1991. The choice of a compliance plan is not a simple task. Every compliance option will be costly. At Ohio Edison, deliberations are quite naturally influenced by past compliance with air quality regulations. This paper discusses compliance with air quality regulations in the 1970's, clean coal technologies and advanced scrubbers, and compliance with air quality regulations in 1995 - 2000. The choice of a compliance strategy for many utilities will involve serving customer loads through some combination of scrubbers, clean coal technologies, fuel switching, fuel blending, redispatch of units, and emissions trading. Whatever the final choice, it must be economic while providing sufficient flexibility to accommodate the critical uncertainties of load growth, state regulatory treatment, markets for emission allowances, advancements in control technologies, additional federal requirements for air emissions, equipment outages and fuel supply disruptions.s

  5. An estimation of the effect of 100% Compliance with Diabetes Treatment: Can we reduce cost of illness with higher compliance rates?

    Directory of Open Access Journals (Sweden)

    Guvenc Kockaya

    2011-01-01

    Full Text Available Introduction: The current study was designed to estimate the direct cost of noncompliance of diabetes patients to the US health system. Understanding these expenses can inform screening and education budget policy regarding expenditure levels that can be calculated to be cost-beneficial. Materials and Method: The study was conducted in three parts. First, a computer search of National Institutes of Health websites and professional society websites for organizations with members that treat diabetes, and a PubMed search were performed to obtain the numbers required for calculations. Second, formulas were developed to estimate the risk of non-compliance and undiagnosed diabetes. Third, risk calculations were performed using the information obtained in part one and the formulas developed in part two. Results: Direct risk reduction for diabetes-related kidney disease, stroke, heart disease, and amputation were estimated for 100% compliance with diabetes treatment. Risk, case and yearly cost reduction calculated for a 100% compliance with diabetes treatment were 13.6%, 0.9 million and US$ 9.3 billion, respectively. Conclusion: Society, insurers, policy makers and other stakeholders could invest up to these amounts in screening, education and prevention efforts in an effort to reduce these costly and traumatic sequelae of noncompliant diabetes patients.   Type: Original Research

  6. Assessing Compliance With Mercaptopurine Treatment in Younger Patients With Acute Lymphoblastic Leukemia in First Remission | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase III trial studies compliance to a mercaptopurine treatment intervention compared to standard of care in younger patients with acute lymphoblastic leukemia in remission. Assessing ways to help patients who have acute lymphoblastic leukemia to take their medications as prescribed may help them in taking their medications more consistently and may improve

  7. Using snowball sampling method with nurses to understand medication administration errors.

    Science.gov (United States)

    Sheu, Shuh-Jen; Wei, Ien-Lan; Chen, Ching-Huey; Yu, Shu; Tang, Fu-In

    2009-02-01

    We aimed to encourage nurses to release information about drug administration errors to increase understanding of error-related circumstances and to identify high-alert situations. Drug administration errors represent the majority of medication errors, but errors are underreported. Effective ways are lacking to encourage nurses to actively report errors. Snowball sampling was conducted to recruit participants. A semi-structured questionnaire was used to record types of error, hospital and nurse backgrounds, patient consequences, error discovery mechanisms and reporting rates. Eighty-five nurses participated, reporting 328 administration errors (259 actual, 69 near misses). Most errors occurred in medical surgical wards of teaching hospitals, during day shifts, committed by nurses working fewer than two years. Leading errors were wrong drugs and doses, each accounting for about one-third of total errors. Among 259 actual errors, 83.8% resulted in no adverse effects; among remaining 16.2%, 6.6% had mild consequences and 9.6% had serious consequences (severe reaction, coma, death). Actual errors and near misses were discovered mainly through double-check procedures by colleagues and nurses responsible for errors; reporting rates were 62.5% (162/259) vs. 50.7% (35/69) and only 3.5% (9/259) vs. 0% (0/69) were disclosed to patients and families. High-alert situations included administration of 15% KCl, insulin and Pitocin; using intravenous pumps; and implementation of cardiopulmonary resuscitation (CPR). Snowball sampling proved to be an effective way to encourage nurses to release details concerning medication errors. Using empirical data, we identified high-alert situations. Strategies for reducing drug administration errors by nurses are suggested. Survey results suggest that nurses should double check medication administration in known high-alert situations. Nursing management can use snowball sampling to gather error details from nurses in a non

  8. Evaluation of Blood Pressure Control Levels and Treatment Compliances of Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Cenk Aypak

    2013-04-01

    Full Text Available Purpose: The aim of the study is to evaluate the knowledge of patients about hypertension (HT, compliance with lifestyle changes and to determine their blood pressure levels under antihypertensive therapy. Method: Hypertensive patients that applied to Family medicine outpatient clinics of Diskapi Yildirim Beyazit Education and Research Hospital for the first time, in 2012 (between February 1 to April 30, were included in our cross-sectional study. Patients are evaluated primarily for the control and the factors that can affect high blood pressure and the rate on achieving treatment goals. Results: Three hundred and forty patients were included in the study. The mean age of the patients was 60.5±10.7 years and 222 of them (65.3% were female. The blood pressure was not under control in 108 (31.8% patients. The mean body weight of male patients was statistically higher than females (p=0.015. The number of the patients that knew the normal blood pressure value was 249 (73.2%. Among those 155 (62.2% were women and 179 (71.9% were younger than 65 years of age (p=0.0001. Forty one patients (12.1% were still smoking, 46 (13.5% patients were exercising regularly and 32 (9.4% were consuming regular diet. Blood pressure was better controlled in the group that was exercising regularly (p=0.001. The rate of male patients that were on regular exercise and diet, were higher than females (p=0.09. Only 86 patients (25.3% knew the name of their antihypertensive medication and 65 of patients (19.1% knew the dose of their medication. Female patients knew the name of their medication better than males (p=0.002. 156 patients (45.9% were using two kinds of antihypertensive medication. 58 patients (17.1% were skipping doses a few times a week. Conclusion: The knowledge of hypertensive patients on their illness and their compliance on non-drug treatments were inadequate. The compliance of patients should be improved by development of patient-doctor should be improved

  9. Globalization and healthcare: understanding health and medical tourism.

    Science.gov (United States)

    Carrera, Percivil M; Bridges, John Fp

    2006-08-01

    Faced with long waiting lists, the high cost of elective treatment and fewer barriers to travel, the idea of availing healthcare in another country is gaining greater appeal to many. The objective of this review is to perform a literature review of health and medical tourism, to define health and medical tourism based on the medical literature and to estimate the size of trade in healthcare. The Medline database was used for our literature review. In our initial search for 'health tourism' and 'medical tourism' we found a paucity of formal literature as well as conceptual ambiguity in the literature. Subsequently, we reviewed the literature on 'tourism' in general and in the context of healthcare. On the basis of 149 papers, we then sought to conceptualize health tourism and medical tourism. Based on our definitions, we likewise sought to estimate market capacity internationally. We defined health tourism as "the organized travel outside one's local environment for the maintenance, enhancement or restoration of an individual's wellbeing in mind and body". A subset of this is medical tourism, which is "the organized travel outside one's natural healthcare jurisdiction for the enhancement or restoration of the individual's health through medical intervention". At the international level, health tourism is an industry sustained by 617 million individuals with an annual growth of 3.9% annually and worth US$513 billion. In conclusion, this paper underscored the issue of a severely limited formal literature that is compounded by conceptual ambiguity facing health and medical tourism scholarship. In clarifying the concepts and standardizing definitions, and providing evidence with regard to the scale of trade in healthcare, we hope to assist in furthering fundamental research tasks, including the further development of reliable and comparable data, the push and pull factors for engaging in health and medical tourism, and the impact of health tourism but, more so, medical

  10. Environmental health and safety issues related to the use of low-level radioactive waste (LLRW) at hospitals and medical research institutions and compliance determination with the Clean Air Act standards

    International Nuclear Information System (INIS)

    Kasinathan, R.; Kanchan, A.

    1995-01-01

    Currently, the United States Nuclear Regulatory Commission (NRC) has standards for procedures, performance activities and technical specifications on storage of Low-Level Radioactive Waste (LLRW) under 10 CFR Part 20. The United States Environmental Protection Agency (EPA) is proposing environmental standards for the management, storage and disposal of LLRW. The proposed standards, which will become 40 CFR part 193 when finalized, limits the committed effective dose to members of the public from the management and storage of LLRW, committed effective doses resulting from LLRW disposal and levels of radiological contamination of underground sources of drinking water as a result of the activities subject to management, storage and disposal of LLRW. Further, under Title III of the Clean Air Act Amendments, radionuclides are required to be inventoried for all generators. For hospitals and medical research institutions, quantities of LLRW are often below the concentrations required under reporting and record keeping requirements of 10 CFR 20. However, in many instances, the facility may require NRC permits and compliance with air quality dispersion modeling requirements. This paper presents the typical radionuclides used in hospitals and medical research institutions, and strategies to evaluate their usage and steps to achieve compliance. Air quality dispersion modeling by use of the COMPLY model is demonstrated to evaluate the fate of radionuclides released from on-site incineration of LLRW. The paper concludes that no significant threat is posed from the incineration of LLRW

  11. Improving physician hand hygiene compliance using behavioural theories: a study protocol

    Directory of Open Access Journals (Sweden)

    Squires Janet E

    2013-02-01

    Full Text Available Abstract Background Healthcare-associated infections affect 10% of patients in Canadian acute-care hospitals and are significant and preventable causes of morbidity and mortality among hospitalized patients. Hand hygiene is among the simplest and most effective preventive measures to reduce these infections. However, compliance with hand hygiene among healthcare workers, specifically among physicians, is consistently suboptimal. We aim to first identify the barriers and enablers to physician hand hygiene compliance, and then to develop and pilot a theory-based knowledge translation intervention to increase physicians’ compliance with best hand hygiene practice. Design The study consists of three phases. In Phase 1, we will identify barriers and enablers to hand hygiene compliance by physicians. This will include: key informant interviews with physicians and residents using a structured interview guide, informed by the Theoretical Domains Framework; nonparticipant observation of physician/resident hand hygiene audit sessions; and focus groups with hand hygiene experts. In Phase 2, we will conduct intervention mapping to develop a theory-based knowledge translation intervention to improve physician hand hygiene compliance. Finally, in Phase 3, we will pilot the knowledge translation intervention in four patient care units. Discussion In this study, we will use a behavioural theory approach to obtain a better understanding of the barriers and enablers to physician hand hygiene compliance. This will provide a comprehensive framework on which to develop knowledge translation interventions that may be more successful in improving hand hygiene practice. Upon completion of this study, we will refine the piloted knowledge translation intervention so it can be tested in a multi-site cluster randomized controlled trial.

  12. Methods for verifying compliance with low-level radioactive waste acceptance criteria

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-09-01

    This report summarizes the methods that are currently employed and those that can be used to verify compliance with low-level radioactive waste (LLW) disposal facility waste acceptance criteria (WAC). This report presents the applicable regulations representing the Federal, State, and site-specific criteria for accepting LLW. Typical LLW generators are summarized, along with descriptions of their waste streams and final waste forms. General procedures and methods used by the LLW generators to verify compliance with the disposal facility WAC are presented. The report was written to provide an understanding of how a regulator could verify compliance with a LLW disposal facility`s WAC. A comprehensive study of the methodology used to verify waste generator compliance with the disposal facility WAC is presented in this report. The study involved compiling the relevant regulations to define the WAC, reviewing regulatory agency inspection programs, and summarizing waste verification technology and equipment. The results of the study indicate that waste generators conduct verification programs that include packaging, classification, characterization, and stabilization elements. The current LLW disposal facilities perform waste verification steps on incoming shipments. A model inspection and verification program, which includes an emphasis on the generator`s waste application documentation of their waste verification program, is recommended. The disposal facility verification procedures primarily involve the use of portable radiological survey instrumentation. The actual verification of generator compliance to the LLW disposal facility WAC is performed through a combination of incoming shipment checks and generator site audits.

  13. Methods for verifying compliance with low-level radioactive waste acceptance criteria

    International Nuclear Information System (INIS)

    1993-09-01

    This report summarizes the methods that are currently employed and those that can be used to verify compliance with low-level radioactive waste (LLW) disposal facility waste acceptance criteria (WAC). This report presents the applicable regulations representing the Federal, State, and site-specific criteria for accepting LLW. Typical LLW generators are summarized, along with descriptions of their waste streams and final waste forms. General procedures and methods used by the LLW generators to verify compliance with the disposal facility WAC are presented. The report was written to provide an understanding of how a regulator could verify compliance with a LLW disposal facility's WAC. A comprehensive study of the methodology used to verify waste generator compliance with the disposal facility WAC is presented in this report. The study involved compiling the relevant regulations to define the WAC, reviewing regulatory agency inspection programs, and summarizing waste verification technology and equipment. The results of the study indicate that waste generators conduct verification programs that include packaging, classification, characterization, and stabilization elements. The current LLW disposal facilities perform waste verification steps on incoming shipments. A model inspection and verification program, which includes an emphasis on the generator's waste application documentation of their waste verification program, is recommended. The disposal facility verification procedures primarily involve the use of portable radiological survey instrumentation. The actual verification of generator compliance to the LLW disposal facility WAC is performed through a combination of incoming shipment checks and generator site audits

  14. Medical radiation physics in Bulgaria

    International Nuclear Information System (INIS)

    Todorov, V.; Vasileva, G.

    1999-01-01

    In Bulgaria medical radiation physics in not yet on a world level. The number of medical physicists working in diagnostic and therapeutic centres is low. Comparatively good is the situation of medical physics in the areas of therapy and radiation protection. But the role of physics in medicine is underestimated as a whole, because of subjective reasons. At the other hand the education in this area is good and very professional. Since 1992 there has been established a specialty 'medical physics' in University of Shoumen and since 1997 the same specialty exists in Sofia University. The situation is expected to be approved with reorganization of the Health System in Bulgaria with compliance with the European standards

  15. 340 Facility compliance assessment

    International Nuclear Information System (INIS)

    English, S.L.

    1993-10-01

    This study provides an environmental compliance evaluation of the RLWS and the RPS systems of the 340 Facility. The emphasis of the evaluation centers on compliance with WAC requirements for hazardous and mixed waste facilities, federal regulations, and Westinghouse Hanford Company (WHC) requirements pertinent to the operation of the 340 Facility. The 340 Facility is not covered under either an interim status Part A permit or a RCRA Part B permit. The detailed discussion of compliance deficiencies are summarized in Section 2.0. This includes items of significance that require action to ensure facility compliance with WAC, federal regulations, and WHC requirements. Outstanding issues exist for radioactive airborne effluent sampling and monitoring, radioactive liquid effluent sampling and monitoring, non-radioactive liquid effluent sampling and monitoring, less than 90 day waste storage tanks, and requirements for a permitted facility

  16. WIPP Regulatory Compliance Strategy and Management Plan for demonstrating compliance to long-term disposal standards

    International Nuclear Information System (INIS)

    1994-05-01

    The primary purpose of this document is to provide a strategy by which the WIPP will demonstrate its ability to perform as a deep geologic repository. The document communicates the DOE's understanding of the regulations related to long-term repository performance; and provides the most efficient strategy that intergrates WIPP Project elements, ensures the sufficiency of information, and provides flexibility for changes in the TRU waste generation system to facilitate the disposal of defense-generated TRU wastes. In addition, this document forms a focal point between the DOE and its various external regulators as well as other stakeholders for the purpose of arriving at compliance decisions that consider all relevant input

  17. Elaboration and Validation of the Medication Prescription Safety Checklist 1

    Science.gov (United States)

    Pires, Aline de Oliveira Meireles; Ferreira, Maria Beatriz Guimarães; do Nascimento, Kleiton Gonçalves; Felix, Márcia Marques dos Santos; Pires, Patrícia da Silva; Barbosa, Maria Helena

    2017-01-01

    ABSTRACT Objective: to elaborate and validate a checklist to identify compliance with the recommendations for the structure of medication prescriptions, based on the Protocol of the Ministry of Health and the Brazilian Health Surveillance Agency. Method: methodological research, conducted through the validation and reliability analysis process, using a sample of 27 electronic prescriptions. Results: the analyses confirmed the content validity and reliability of the tool. The content validity, obtained by expert assessment, was considered satisfactory as it covered items that represent the compliance with the recommendations regarding the structure of the medication prescriptions. The reliability, assessed through interrater agreement, was excellent (ICC=1.00) and showed perfect agreement (K=1.00). Conclusion: the Medication Prescription Safety Checklist showed to be a valid and reliable tool for the group studied. We hope that this study can contribute to the prevention of adverse events, as well as to the improvement of care quality and safety in medication use. PMID:28793128

  18. MULTIDISCIPLINARY APPROACH TO SUPPORTING TREATMENT COMPLIANCE IN TUBERCULOSIS PATIENTS

    Directory of Open Access Journals (Sweden)

    T. V. Sherstneva

    2017-01-01

    Full Text Available The article presents the algorithm for working with tuberculosis patients in TB hospital, providing implementation of multidisciplinary patient-centered activities for early diagnostics of psychiatric and social disorders, therapy and rehabilitation of concurrent psychiatric disorders and addictions. Multidisciplinary approach to activities within TB unit is aimed at improvement of treatment compliance of tuberculosis patients. The training programme has been developed in order to improve competency of medical personnel on the issue of treatment interruption prevention and motivating patients to undergo the continuous treatment.

  19. Assessment of Compliance to Treatment of Diabetes and Hypertension amongst Previously Diagnosed Patients from Rural Community of Raigad District of Maharashtra.

    Science.gov (United States)

    Kakumani, Kiranmayi Venkata; Waingankar, Prasad

    2016-12-01

    Substantial burden of diabetes and hypertension is on rise in India, leading to a twin epidemic. India, being a rural country, has unique problems regarding the treatment compliance which is a serious risk for morbidity and mortality. To assess the compliance to treatment of hypertension and diabetes amongst the diagnosed patients from rural area and to study reasons of non-compliance and knowledge and attitude. Community based, cross sectional, observational study conducted in the rural communities of Tara and Barapada villages of Raigad district of Maharashtra. Survey was conducted covering population of 2115 across 360 families, 250 at Barapada and 110 at Tara. All the cases of diabetes and hypertension diagnosed for more than one year were included. A structured and pre-tested questionnaire was administered including details on demography, medical documentation, treatment details and factors assessing the compliance, knowledge and attitude towards the diseases. When reviewed the treatment adherence pattern based on documentary evidence and interview of the patient, on history of taking medication strictly since the detection illness, it was found that more than 70% of the Diabetics and more than 75% of the Hypertensive have discontinued the treatment in between. The most common reasons of non-compliance is the lack of sufficient motivation for treatment adherence as many mentioned (61.4% diabetics, 55.8% hypertensives) difficulty to remember to take daily medication due to work or forgetfulness. This is followed by lack of money (50%diabetics, 55.8% hypertensives) and living far away from doctor in city (43% diabetics and 46% hypertensives). The study findings are only tip of iceberg and the non-adherence to the treatment of diabetes and hypertension in rural population is at alarmingly high. Illiteracy, lack of faith in treatment and motivation, unawareness and self-neglect as well as financial constraints and lack of specialist care in rural area is playing

  20. A randomized trial to determine the impact on compliance of a psychophysical peripheral cue based on the Elaboration Likelihood Model.

    Science.gov (United States)

    Horton, Rachael Jane; Minniti, Antoinette; Mireylees, Stewart; McEntegart, Damian

    2008-11-01

    Non-compliance in clinical studies is a significant issue, but causes remain unclear. Utilizing the Elaboration Likelihood Model of persuasion, this study assessed the psychophysical peripheral cue 'Interactive Voice Response System (IVRS) call frequency' on compliance. 71 participants were randomized to once daily (OD), twice daily (BID) or three times daily (TID) call schedules over two weeks. Participants completed 30-item cognitive function tests at each call. Compliance was defined as proportion of expected calls within a narrow window (+/- 30 min around scheduled time), and within a relaxed window (-30 min to +4 h). Data were analyzed by ANOVA and pairwise comparisons adjusted by the Bonferroni correction. There was a relationship between call frequency and compliance. Bonferroni adjusted pairwise comparisons showed significantly higher compliance (p=0.03) for the BID (51.0%) than TID (30.3%) for the narrow window; for the extended window, compliance was higher (p=0.04) with OD (59.5%), than TID (38.4%). The IVRS psychophysical peripheral cue call frequency supported the ELM as a route to persuasion. The results also support OD strategy for optimal compliance. Models suggest specific indicators to enhance compliance with medication dosing and electronic patient diaries to improve health outcomes and data integrity respectively.

  1. Influence of Handprint Culture Training on Compliance of Healthcare Workers with Hand Hygiene

    Directory of Open Access Journals (Sweden)

    Hala Fouad

    2018-01-01

    Full Text Available Objective. We aimed to study the effect of visual observation of bacterial growth from handprints on healthcare workers’ (HCWs compliance with hand hygiene (HH. Settings. Medical and postoperative cardiac surgery units. Design. Prospective cohort study. Subject. The study included 40 HCWs. Intervention. Each HCW was interviewed on 3 separate occasions. The 1st interview was held to obtain a handprint culture before and after a session demonstrating the 7 steps of HH using alcohol-based hand rub, allowing comparison of results before and after HH. A 2nd interview was held 6 weeks later to obtain handprint culture after HH. A 3rd interview was held to obtain a handprint culture before HH. One month before implementation of handprint cultures and during the 12-week study period, monitoring of HCWs for compliance with HH was observed by 2 independent observers. Main Results. There was a significant improvement in HH compliance following handprint culture interview (p<0.001. The frequency of positive cultures, obtained from patients with suspected healthcare-associated infections, significantly declined (blood cultures: p=0.001; wound cultures: p = 0,003; sputum cultures: p=0.005. Conclusion. The visual message of handprint bacterial growth before and after HH seems an effective method to improve HH compliance.

  2. Physicians′ therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria

    Directory of Open Access Journals (Sweden)

    Nahla Khamis R Ibrahim

    2010-01-01

    Full Text Available Objectives: The objectives of the study were to investigate physician′s therapeutic practice and the compliance of diabetic patients attending rural primary health units in Alexandria. Material and Methods: A cross-sectional study was conducted and a multistage stratified random sample method was used for the selection of 600 diabetic patients. Data were collected by means of an interviewing questionnaire, an observation checklist, review of prescriptions and laboratory investigations. A scoring system was made for a diabetic patient′s knowledge and skills, patient′s compliance, doctor-patient relationship, and glycemic control. Results: About 57% always took their medication as prescribed by doctor and on time, only 2.2% always complied with dietary regimen while no one reported regular compliance with exercise regimen. Complications of the regimen was the commonest cause (63.3% of noncompliance. A highly statistically significant difference was found between compliance with all regimens and patient′s knowledge of diabetes. The scores for doctor-patient relationship were all unsatisfactory. Results of glycosylated hemoglobin (HbA1c revealed that metabolic control of four-fifth of the patients was satisfactory, 12% had fair and 8% had poor metabolic control. Conclusions: Patient′s compliance with most of the diabetes regimen was low. Doctor-patient relationship and patient′s compliance should be improved by conducting educational and training programs.

  3. Central line-associated blood stream infections in pediatric ICUs: Longitudinal trends and compliance with bundle strategies

    Science.gov (United States)

    Edwards, Jeffrey D; Herzig, Carolyn TA; Liu, Hangsheng; Pogorzelska-Maziarz, Monika; Zachariah, Philip; Dick, Andrew W; Saiman, Lisa; Stone, Patricia W; Furuya, E Yoko

    2015-01-01

    Background Knowing the temporal trend central line-associated bloodstream infection (CLABSI) rates among U.S. pediatric intensive care units (PICU), the current extent of CL bundle compliance, and the impact of compliance on rates is necessary to understand what has been accomplished and can be improved in CLABSI prevention. Methods Longitudinal study of PICUs in National Healthcare Safety Network hospitals and a cross-sectional survey of directors/managers of infection prevention & control departments regarding PICU CLABSI prevention practices, including self-reported compliance with elements of central line bundles. Associations between 2011/12 PICU CLABSI rates and infection prevention practices were examined. Results Reported CLABSI rates decreased during the study period, from 5.8 per 1000 line days in 2006 to 1.4 in 2011/12 (Pprevention practices, only 35% of those with policies reported ≥95% compliance. PICUs with ≥95% compliance with central line infection prevention policies had lower reported CLABSI rates, but this association was statistically insignificant. Conclusions There was a non-significant trend in decreasing CLABSI rates as PICUs improved bundle policy compliance. Given that few PICUs reported full compliance with these policies, PICUs increasing their efforts to comply with these policies may help reduce CLABSI rates. PMID:25952048

  4. Understanding the Use of Educational Technology among Faculty, Staff, and Students at a Medical University

    Science.gov (United States)

    Kazley, Abby Swanson; Annan, Dustin L.; Carson, Nancy E.; Freeland, Melissa; Hodge, Ashley B.; Seif, Gretchen A.; Zoller, James S.

    2013-01-01

    A college of health professions at a medical university located in the southeastern United States is striving to increase the use of educational technology among faculty, staff, and students. A strategic planning group was formed and charged with enhancing the use of educational technology within the college. In order to understand the current…

  5. Guideline compliance in chronic heart failure patients with multiple comorbid diseases: evaluation of an individualised multidisciplinary model of care.

    Directory of Open Access Journals (Sweden)

    Tam H Ho

    Full Text Available OBJECTIVE: To assess the impact of individualised, reconciled evidence-based recommendations (IRERs and multidisciplinary care in patients with chronic heart failure (CHF on clinical guideline compliance for CHF and common comorbid conditions. DESIGN AND SETTING: A retrospective hospital clinical audit conducted between 1st July 2006 and February 2011. PARTICIPANTS: A total of 255 patients with a diagnosis of CHF who attended the Multidisciplinary Ambulatory Consulting Services (MACS clinics, at the Royal Adelaide Hospital, were included. MAIN OUTCOME MEASURES: Compliance with Australian clinical guideline recommendations for CHF, atrial fibrillation, diabetes mellitus and ischaemic heart disease. RESULTS: Study participants had a median of eight medical conditions (IQR 6-10 and were on an average of 10 (±4 unique medications. Compliance with clinical guideline recommendations for pharmacological therapy for CHF, comorbid atrial fibrillation, diabetes or ischaemic heart disease was high, ranging from 86% for lipid lowering therapy to 98% anti-platelet agents. For all conditions, compliance with lifestyle recommendations was lower than pharmacological therapy, ranging from no podiatry reviews for CHF patients with comorbid diabetes to 75% for heart failure education. Concordance with many guideline recommendations was significantly associated if the patient had IRERs determined, a greater number of recommendations, more clinic visits or if patients participated in a heart failure program. CONCLUSIONS: Despite the high number of comorbid conditions and resulting complexity of the management, high compliance to clinical guideline recommendations was associated with IRER determination in older patients with CHF. Importantly these recommendations need to be communicated to the patient's general practitioner, regularly monitored and adjusted at clinic visits.

  6. The roles of safety and compliance in determining effectiveness of topical therapy for psoriasis.

    Science.gov (United States)

    Stein Gold, Linda; Corvari, Linda

    2007-01-01

    Topical therapies are the mainstays of treatment for most patients with psoriasis because they relieve symptoms and reduce the size and severity of lesions. The effectiveness of a therapeutic intervention is a function of drug efficacy (determined by randomized clinical trial results) and patient safety and compliance. Alterations in any parameter can have a substantial influence on clinical outcomes. However, topical agents can be associated with unwanted and potentially toxic side effects that make physicians reluctant to prescribe them, and patients intentionally discontinue treatment with these topical agents. To maximize effectiveness and improve patient safety, physicians may prescribe medications in combination, sequential, or rotational therapeutic regimens. This treatment strategy has the potential to improve the overall efficacy and safety of topical therapy; however, the effectiveness of this method may be compromised because the complexity of the therapeutic regimen may decrease patient compliance. Newer topical therapies that have a convenient once-daily dosing schedule are needed and will have important implications for patient compliance.

  7. The Influence of Corporate Governance And Firm’s Characteristics on The Extent of Compliance With Masb Standards Among Malaysian Listed Companies

    OpenAIRE

    Azhar Abdul Rahman, PhD; Ku Nor Izah Ku Ismail, PhD; Wan Nordin Wan Hussin, PhD

    2013-01-01

    This paper contributes to our understanding of compliance with mandatory accounting standards. Specifically, we examine the efficacy of agency related mechanisms on the degree of disclosure compliance with the Malaysian Accounting Standards Board (MASB) accounting standards. Using data drawn from a sample of 170 Malaysian companies listed on the Kuala Lumpur Stock Exchange (KLSE) in 2004, we show that although overall disclosure compliance is high (85.2% of the items of information being disc...

  8. Compliance and Enforcement Actions (CEA) -

    Data.gov (United States)

    Department of Transportation — Compliance and Enforcement Actions application provides process assistance / improvements for conducting investigation and enforcement activities. The Compliance and...

  9. Strategisk compliance og regulering

    DEFF Research Database (Denmark)

    Kühn Pedersen, Mogens

    2016-01-01

    Denne artikel introducerer strategisk compliance og påpeger dens samspil med klassiske og nyere former for reguleringer i digital værdiskabelse. Konteksten er den digitale økonomi, som vokser frem imellem den materielle økonomis bærepiller: Virksomheder og markeder, men består af en helt ny...... materialitet, som er det digitale univers og dets modsvarighed i nye krav til compliance. Den nye materialitet stiller nye krav, hvad angår digitale processer og transaktioner. Klassisk regulering, som aktører ikke selv kan ændre, støder på egenregulering, hvor aktørerne selv opsætter regler for at skabe...... digital værdi. Dette kalder på strategisk compliance. Med digitalisering er strategisk compliance sat på dagsordnen i reguleringsdebatten. Vi hævder, at regulering og egenregulering kan komme til at virke komplementært i det post-industrielle, digitaliserede samfund....

  10. Recovery Audit Contractor medical necessity readiness: one health system's journey.

    Science.gov (United States)

    Scott, Judith A; Camden, Mindy

    2011-01-01

    To develop a sustainable approach to Recovery Audit Contractor medical necessity readiness that mitigates the regulatory and financial risks of the organization. Acute care hospitals. Utilizing the model for improvement and plan-do-study-act methodology, this health system designed and implemented a medical necessity case management program. We focused on 3 areas for improvement: medical necessity review accuracy, review timeliness, and physician adviser participation for secondary reviews. Over several months, we improved accuracy and timeliness of our medical necessity reviews while also generating additional inpatient revenue for the health system. We successfully enhanced regulatory compliance and reduced our financial risks associated with Recovery Audit Contractor medical necessity audits. A successful medical necessity case management program can not only enhance regulatory compliance and reduce the amount of payments recouped by Medicare, but also generate additional inpatient revenue for your organization. With health care reform and accountable care organizations on the horizon, hospitals must find ways to protect and enhance revenue in order to carry out their missions. This is one way for case managers to help in that cause, to advocate for the care of their patients, and to bring value to the organization.

  11. Speaking the right language: the scientific method as a framework for a continuous quality improvement program within academic medical research compliance units.

    Science.gov (United States)

    Nolte, Kurt B; Stewart, Douglas M; O'Hair, Kevin C; Gannon, William L; Briggs, Michael S; Barron, A Marie; Pointer, Judy; Larson, Richard S

    2008-10-01

    The authors developed a novel continuous quality improvement (CQI) process for academic biomedical research compliance administration. A challenge in developing a quality improvement program in a nonbusiness environment is that the terminology and processes are often foreign. Rather than training staff in an existing quality improvement process, the authors opted to develop a novel process based on the scientific method--a paradigm familiar to all team members. The CQI process included our research compliance units. Unit leaders identified problems in compliance administration where a resolution would have a positive impact and which could be resolved or improved with current resources. They then generated testable hypotheses about a change to standard practice expected to improve the problem, and they developed methods and metrics to assess the impact of the change. The CQI process was managed in a "peer review" environment. The program included processes to reduce the incidence of infections in animal colonies, decrease research protocol-approval times, improve compliance and protection of animal and human research subjects, and improve research protocol quality. This novel CQI approach is well suited to the needs and the unique processes of research compliance administration. Using the scientific method as the improvement paradigm fostered acceptance of the project by unit leaders and facilitated the development of specific improvement projects. These quality initiatives will allow us to improve support for investigators while ensuring that compliance standards continue to be met. We believe that our CQI process can readily be used in other academically based offices of research.

  12. Increasing nursing students' understanding and accuracy with medical dose calculations: A collaborative approach.

    Science.gov (United States)

    Mackie, Jane E; Bruce, Catherine D

    2016-05-01

    Accurate calculation of medication dosages can be challenging for nursing students. Specific interventions related to types of errors made by nursing students may improve the learning of this important skill. The objective of this study was to determine areas of challenge for students in performing medication dosage calculations in order to design interventions to improve this skill. Strengths and weaknesses in the teaching and learning of medication dosage calculations were assessed. These data were used to create online interventions which were then measured for the impact on student ability to perform medication dosage calculations. The setting of the study is one university in Canada. The qualitative research participants were 8 nursing students from years 1-3 and 8 faculty members. Quantitative results are based on test data from the same second year clinical course during the academic years 2012 and 2013. Students and faculty participated in one-to-one interviews; responses were recorded and coded for themes. Tests were implemented and scored, then data were assessed to classify the types and number of errors. Students identified conceptual understanding deficits, anxiety, low self-efficacy, and numeracy skills as primary challenges in medication dosage calculations. Faculty identified long division as a particular content challenge, and a lack of online resources for students to practice calculations. Lessons and online resources designed as an intervention to target mathematical and concepts and skills led to improved results and increases in overall pass rates for second year students for medication dosage calculation tests. This study suggests that with concerted effort and a multi-modal approach to supporting nursing students, their abilities to calculate dosages can be improved. The positive results in this study also point to the promise of cross-discipline collaborations between nursing and education. Copyright © 2016 Elsevier Ltd. All rights

  13. Determinants of compliance with anti-vectorial protective measures among non-immune travellers during missions to tropical Africa.

    Science.gov (United States)

    Sagui, Emmanuel; Resseguier, Noémie; Machault, Vanessa; Ollivier, Lénaïck; Orlandi-Pradines, Eve; Texier, Gaetan; Pages, Frédéric; Michel, Remy; Pradines, Bruno; Briolant, Sébastien; Buguet, Alain; Tourette-Turgis, Catherine; Rogier, Christophe

    2011-08-10

    The effectiveness of anti-vectorial malaria protective measures in travellers and expatriates is hampered by incorrect compliance. The objective of the present study was to identify the determinants of compliance with anti-vectorial protective measures (AVPMs) in this population that is particularly at risk because of their lack of immunity. Compliance with wearing long clothing, sleeping under insecticide-impregnated bed nets (IIBNs) and using insect repellent was estimated and analysed by questionnaires administered to 2,205 French military travellers from 20 groups before and after short-term missions (approximately four months) in six tropical African countries (Senegal, Ivory Coast, Chad, Central African Republic, Gabon and Djibouti). For each AVPM, the association of "correct compliance" with individual and collective variables was investigated using random-effect mixed logistic regression models to take into account the clustered design of the study. The correct compliance rates were 48.6%, 50.6% and 18.5% for wearing long clothing, sleeping under bed nets and using repellents, respectively. Depending on the AVPM, correct compliance was significantly associated with the following factors: country, older than 24 years of age, management responsibilities, the perception of a personal malaria risk greater than that of other travellers, the occurrence of life events, early bedtime (i.e., before midnight), the type of stay (field operation compared to training), the absence of medical history of malaria, the absence of previous travel in malaria-endemic areas and the absence of tobacco consumption.There was no competition between compliance with the different AVPMs or between compliance with any AVPM and malaria chemoprophylaxis. Interventions aimed at improving compliance with AVPMs should target young people without management responsibilities who are scheduled for non-operational activities in countries with high risk of clinical malaria. Weak associations

  14. Motivation and compliance with intraoral elastics.

    Science.gov (United States)

    Veeroo, Helen J; Cunningham, Susan J; Newton, Jonathon Timothy; Travess, Helen C

    2014-07-01

    Intraoral elastics are commonly used in orthodontics and require regular changing to be effective. Unfortunately, poor compliance with elastics is often encountered, especially in adolescents. Intention for an action and its implementation can be improved using "if-then" plans that spell out when, where, and how a set goal, such as elastic wear, can be put into action. Our aim was to determine the effect of if-then plans on compliance with elastics. To identify common barriers to compliance with recommendations concerning elastic wear, semistructured interviews were carried out with 14 adolescent orthodontic patients wearing intraoral elastics full time. Emerging themes were used to develop if-then plans to improve compliance with elastic wear. A prospective pilot study assessed the effectiveness of if-then planning aimed at overcoming the identified barriers on compliance with elastic wear. Twelve participants were randomized equally into study and control groups; the study group received information about if-then planning. The participants were asked to collect used elastics, and counts of these were used to assess compliance. A wide range of motivational and volitional factors were described by the interviewed participants, including the perceived benefits of elastics, cues to remember, pain, eating, social situations, sports, loss of elastics, and breakages. Compliance with elastic wear was highly variable among patients. The study group returned more used elastics, suggesting increased compliance, but the difference was not significant. The use of if-then plans might improve compliance with elastic wear when compared with routine clinical instructions. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  15. Australian Children's Understanding of Display Rules

    Science.gov (United States)

    Choy, Grace

    2009-01-01

    Cultural display rules govern the manifestation of emotional expressions. In compliance with display rules, the facial expressions displayed (i.e. apparent emotion) may be incongruent with the emotion experienced (i.e. real emotion). This study investigates Australian Caucasian children's understanding of display rules. A sample of 80 four year…

  16. Rational noncompliance with prescribed medical treatment.

    Science.gov (United States)

    Stewart, Douglas O; DeMarco, Joseph P

    2010-09-01

    Despite the attention that patient noncompliance has received from medical researchers, patient noncompliance remains poorly understood and difficult to alter. With a better theory of patient noncompliance, both greater success in achieving compliance and greater respect for patient decision making are likely. The theory presented, which uses a microeconomic approach, bridges a gap in the extant literature that has so far ignored the contributions of this classic perspective on decision making involving the tradeoff of costs and benefits. The model also generates a surprising conclusion: that patients are typically acting rationally when they refuse to comply with certain treatments. However, compliance is predicted to rise with increased benefits and reduced costs. The prediction that noncompliance is rational is especially true in chronic conditions at the point that treatment begins to move closer to the medically ideal treatment level. Although the details of this theory have not been tested empirically, it is well supported by existing prospective and retrospective studies.

  17. [Study on the use of a smart pillbox to improve treatment compliance].

    Science.gov (United States)

    Morales Suárez-Varela, María Teresa

    2009-04-01

    To assess the usefulness of the Practidose individualised dispensing and dosing pillbox system in improving treatment compliance (TC). Open-labelled, randomised, clinical trial. Cordoba province from April to September 2005. A total of 220 patients 70 years diagnosed with ineffective management of treatment regime, polymedicated with no cognitive deterioration or limited mobility. Enrolment was carried out by block random assignment. Each district linking nurse was assigned 10 interviews, 5 from the intervention group and 5 from a control group. To give a smart pillbox with instructions. MEASUREMENTS AND PRIMARY OUTCOMES: The response variable was the TC measured using the Morisky-Green questionnaire at the beginning and at 2 months. The independent variables were: age, sex, education level, number of people living in the home and mean age, diabetes, hypertension, heart disease, COPD, number of medications, number of daily and weekly doses self-medication, and interest in the patient information leaflet. A descriptive analysis and a multiple logistic regression were performed on the data. A total of 182 patients finished the study. The TC improved by 6.74% in the intervention group and by 2.15% in the control group. To look after the medications and suffer from COPD lead to better TC, and was less so when there was interest in the patient information leaflet. The improvement in treatment compliance with the Practidose Pillbox was not statistically significant, although a positive tendency was observed.

  18. An ontological knowledge framework for adaptive medical workflow.

    Science.gov (United States)

    Dang, Jiangbo; Hedayati, Amir; Hampel, Ken; Toklu, Candemir

    2008-10-01

    As emerging technologies, semantic Web and SOA (Service-Oriented Architecture) allow BPMS (Business Process Management System) to automate business processes that can be described as services, which in turn can be used to wrap existing enterprise applications. BPMS provides tools and methodologies to compose Web services that can be executed as business processes and monitored by BPM (Business Process Management) consoles. Ontologies are a formal declarative knowledge representation model. It provides a foundation upon which machine understandable knowledge can be obtained, and as a result, it makes machine intelligence possible. Healthcare systems can adopt these technologies to make them ubiquitous, adaptive, and intelligent, and then serve patients better. This paper presents an ontological knowledge framework that covers healthcare domains that a hospital encompasses-from the medical or administrative tasks, to hospital assets, medical insurances, patient records, drugs, and regulations. Therefore, our ontology makes our vision of personalized healthcare possible by capturing all necessary knowledge for a complex personalized healthcare scenario involving patient care, insurance policies, and drug prescriptions, and compliances. For example, our ontology facilitates a workflow management system to allow users, from physicians to administrative assistants, to manage, even create context-aware new medical workflows and execute them on-the-fly.

  19. Therapeutic compliance of first line disease-modifying therapies in patients with multiple sclerosis. COMPLIANCE Study.

    Science.gov (United States)

    Saiz, A; Mora, S; Blanco, J

    2015-05-01

    Non-adherence to disease-modifying therapies (DMTs) in multiple sclerosis may be associated with reduced efficacy. We assessed compliance, the reasons for non-compliance, treatment satisfaction, and quality of life (QoL) of patients treated with first-line therapies. A cross-sectional, multicenter study was conducted that included relapsing multiple sclerosis patients. Compliance in the past month was assessed using Morisky-Green test. Seasonal compliance and reasons for non-compliance were assessed by an ad-hoc questionnaire. Treatment satisfaction and QoL were evaluated by means of TSQM and PRIMUS questionnaires. A total of 220 patients were evaluated (91% relapsing-remitting); the mean age was 39.1 years, 70% were female, and the average time under treatment was 5.4 years. Subcutaneous interferon (IFN) β-1b was used in 23% of the patients, intramuscular IFN β-1a in 21%, subcutaneous IFN β-1a in 37%, and with glatiramer acetate in 19%. The overall compliance was 75%, with no significant differences related to the therapy, and 81% did not report any seasonal variation. Compliant patients had significantly lower disability scores and time of diagnosis, and greater satisfaction with treatment and its effectiveness. Discomfort and flu-like symptoms were the most frequent reasons for non-compliance. The satisfaction and QoL were associated with less disability and number of therapeutic switches. The rate of compliance, satisfaction and QoL in multiple sclerosis patients under DMTs is high, especially for those newly diagnosed, less disabled, and with fewer therapeutic switches. Discomfort and flu-like symptoms associated with injected therapies significantly affect adherence. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  20. Cracking the Code: Assessing Institutional Compliance with the Australian Code for the Responsible Conduct of Research

    Science.gov (United States)

    Morris, Suzanne E.

    2010-01-01

    This paper provides a review of institutional authorship policies as required by the "Australian Code for the Responsible Conduct of Research" (the "Code") (National Health and Medical Research Council (NHMRC), the Australian Research Council (ARC) & Universities Australia (UA) 2007), and assesses them for Code compliance.…

  1. Extrinsic incentives and tax compliance

    OpenAIRE

    Sour, Laura; Gutiérrez Andrade, Miguel Ángel

    2011-01-01

    This paper models the impact of extrinsic incentives in a tax compliance model. It also provides experimental evidence that confirms the existence of a positive relationship between rewards and tax compliance. If individuals are audited, rewards for honest taxpayers are effective in increasing the level of tax compliance. These results are particularly relevant in countries where there is little respect for tax law since rewards can contribute to crowding in the intrinsic motivation to comply.

  2. [Doctor-Patient Relationship from the Perspective of Medical Students' Portfolio].

    Science.gov (United States)

    Girela Pérez, Beatriz; Rodríguez Cano, María Araceli; Girela López, Eloy

    2018-01-01

    Doctor-patient relationship is of paramount importance for a good medical practice, however as long as medicine has been increasingly influenced by technology and science, it may be at risk of losing contact with basic human values of respect for the beliefs and preferences of the other person. In this study, we have analyzed the deontological vision of the physician-patient relationship perceived through clinical situations reflected in the portfolios carried out by 225 students of the 5th year of the Degree of Medicine at the University of Córdoba, during the courses 2014/15 and 2015/16. 201 out of 833 deontological considerations on articles of the Code of Medical Ethics constitute non-compliances. It is noteworthy that these breaches to the Code of Medical Ethics considered refer mainly (73%) to Chapter III (doctor-patient relationship). It is particularly interesting that the problems most frequently detected are those related to attitude, forms or language and lack of understanding/confidence of the physician with the patient (article 8 with 46 noncompliances), as well as problems in providing information (articles 12.1 and 15, with 18 and 42 noncompliances respectively).

  3. Can achievement emotions be used to better understand motivation, learning, and performance in medical education?

    Science.gov (United States)

    Artino, Anthony R; Holmboe, Eric S; Durning, Steven J

    2012-01-01

    In this article, we consider an emergent theory of human emotion. The overarching purpose of the article is to introduce medical education researchers to the notion of achievement emotions and provide a brief overview of how this work can inform the theory, research, and practice of medical education. First, we define achievement emotions and describe one of the leading contemporary theories of achievement emotions, control-value theory (Pekrun R. 2006. The control-value theory of achievement emotions: Assumptions, corollaries, and implications for educational research and practice. Educ Psychol Rev 18:315-341.). Next, we distinguish between different types of achievement emotions, their proximal causes, and their consequences for motivation, learning, and performance, and we discuss several implications for educational practice. Finally, we end with a call for more research on achievement emotions in medical education to facilitate our understanding of emotions and their impact on important educational outcomes.

  4. Understanding IBD Medications and Side Effects

    Science.gov (United States)

    ... important not to suddenly stop taking this medication. Immunomodulators: These include azathioprine, 6-mercaptopurine (6-MP), methotrexate, ... ongoing inflammation. Usually given orally (methotrexate is injectable), immunomodulators are typically used in people for whom aminosalicylates ...

  5. On the validity of language: speaking, knowing and understanding in medical geography.

    Science.gov (United States)

    Scarpaci, J L

    1993-09-01

    This essay examines methodological problems concerning the conceptualization and operationalization of phenomena central to medical geography. Its main argument is that qualitative research can be strengthened if the differences between instrumental and apparent validity are better understood than the current research in medical geography suggests. Its premise is that our definitions of key terms and concepts must be reinforced throughout the design of research should our knowledge and understanding be enhanced. In doing so, the paper aims to move the methodological debate beyond the simple dichotomies of quantitative vs qualitative approaches and logical positivism vs phenomenology. Instead, the argument is couched in a postmodernist hermeneutic sense which questions the validity of one discourse of investigation over another. The paper begins by discussing methods used in conceptualizing and operationalizing variables in quantitative and qualitative research design. Examples derive from concepts central to a geography of health-care behavior and well-being. The latter half of the essay shows the uses and misuses of validity studies in selected health services research and the current debate on national health insurance.

  6. 22 CFR 209.6 - Compliance information.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Compliance information. 209.6 Section 209.6... § 209.6 Compliance information. (a) Cooperation and assistance. The Administrator shall to the fullest... and accurate compliance reports at such times, and in such form and containing such information, as...

  7. Determining next steps in a hand hygiene improvement initiative by examining variation in hand hygiene compliance rates.

    Science.gov (United States)

    Homa, Karen; Kirkland, Kathryn B

    2011-01-01

    Health care worker hand hygiene (HH) is a major quality and safety concern since poor hand hygiene has been linked with hospital associated infections. Dartmouth-Hitchcock Medical Center has been involved in a 4-year initiative to improve hand hygiene. In 2006, HH compliance occurred 41% of the time and by 2009, it had improved to 91%. We wanted to understand some of the unexplained variability in HH to help determine where to target more specific strategies. To help determine where some of the variability in HH compliance rates occurred, an analysis of means chart was used to determine whether role type of the health care worker and hospital areas had significantly different HH rates compared with the overall HH rate. The overall HH rate between March 2008 and December 2009 was 87%. There was a wide and significant variation between the 16 groups of 2 types of health care workers in 8 hospital areas from the lowest rate of 64% to a high of 96%. Analysis of means revealed significant differences in HH rates relative to the type of worker and hospital areas. Although the method does not inform the organization of what type of intervention will work where and why, it allows high and low performing groups to be identified, so that organizations can learn from them to generate and test theories.

  8. The USAID Environmental Compliance Database

    Data.gov (United States)

    US Agency for International Development — The Environmental Compliance Database is a record of environmental compliance submissions with their outcomes. Documents in the database can be found by visiting the...

  9. Understanding Medications and What They Do

    Science.gov (United States)

    ... only in hospitals. What Are Medicines? Medicines are chemicals or compounds used to cure, halt, or prevent disease; ease symptoms; or help in the diagnosis of illnesses. Advances in medications have enabled doctors to cure many ...

  10. Quality and correlates of medical record documentation in the ambulatory care setting

    Directory of Open Access Journals (Sweden)

    Simon Steven R

    2002-12-01

    Full Text Available Abstract Background Documentation in the medical record facilitates the diagnosis and treatment of patients. Few studies have assessed the quality of outpatient medical record documentation, and to the authors' knowledge, none has conclusively determined the correlates of chart documentation. We therefore undertook the present study to measure the rates of documentation of quality of care measures in an outpatient primary care practice setting that utilizes an electronic medical record. Methods We reviewed electronic medical records from 834 patients receiving care from 167 physicians (117 internists and 50 pediatricians at 14 sites of a multi-specialty medical group in Massachusetts. We abstracted information for five measures of medical record documentation quality: smoking history, medications, drug allergies, compliance with screening guidelines, and immunizations. From other sources we determined physicians' specialty, gender, year of medical school graduation, and self-reported time spent teaching and in patient care. Results Among internists, unadjusted rates of documentation were 96.2% for immunizations, 91.6% for medications, 88% for compliance with screening guidelines, 61.6% for drug allergies, 37.8% for smoking history. Among pediatricians, rates were 100% for immunizations, 84.8% for medications, 90.8% for compliance with screening guidelines, 50.4% for drug allergies, and 20.4% for smoking history. While certain physician and patient characteristics correlated with some measures of documentation quality, documentation varied depending on the measure. For example, female internists were more likely than male internists to document smoking history (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.27 – 2.83 but were less likely to document drug allergies (OR, 0.51; 95% CI, 0.35 – 0.75. Conclusions Medical record documentation varied depending on the measure, with room for improvement in most domains. A variety of

  11. 24 CFR 107.40 - Compliance meeting.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Compliance meeting. 107.40 Section... NONDISCRIMINATION AND EQUAL OPPORTUNITY IN HOUSING UNDER EXECUTIVE ORDER 11063 § 107.40 Compliance meeting. (a... allegedly in violation (respondent) shall be sent a Notice of Compliance Meeting and requested to attend a...

  12. Managing compliance risk after Mifid

    OpenAIRE

    P. Musile Tanzi; G. Gabbi; D. Previati; P. Schwizer

    2013-01-01

    Purpose – The purpose of this paper is to focus on changes in the compliance function within major European banks and other financial intermediaries and on the effects of Markets in Financial Instruments Directive (MiFID) implementation. Design/methodology/approach – The four areas of research seek to answer the following questions: Is the positioning of the compliance function “at the top” of the organizational structure? Are the roles attributed to the compliance function, th...

  13. Providing detailed information about latent tuberculosis and compliance with the PPD test among healthcare workers in Israel: A randomized controlled study

    Directory of Open Access Journals (Sweden)

    Danielle Taubman

    2013-12-01

    Conclusions: Compliance for latent TB screening is low among HCWs in northeastern Israel. Providing detailed information about latent TB was not associated with increased test compliance. Understanding existing disparities in screening rates and potential barriers to latent TB screening among HCWs is important in order to move forward and successfully increase screening rates.

  14. 24 CFR 108.25 - Compliance meeting.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Compliance meeting. 108.25 Section... COMPLIANCE PROCEDURES FOR AFFIRMATIVE FAIR HOUSING MARKETING § 108.25 Compliance meeting. (a) Scheduling meeting. If an applicant fails to comply with requirements under § 108.15 or § 108.20 or it appears that...

  15. Medical Prescription Pitfalls of Uncomplicated Urinary Tract ...

    African Journals Online (AJOL)

    Objectives: The aim of this evaluation was to identify pitfalls in medical prescriptions of uncomplicated urinary tract infections in government healthcare facilities in Zambia. Design: This was a cross sectional and government healthcare facilities were conveniently sampled. Main outcome measures: Rate of compliance to ...

  16. Medical abortion: understanding perspectives of rural and marginalized women from rural South India.

    Science.gov (United States)

    Sri, B Subha; Ravindran, T K Sundari

    2012-09-01

    To understand how rural and other groups of marginalized women define safe abortion; their perspectives and concerns regarding medical abortion (MA); and what factors affect their access to safe abortion. Focus group discussions were held with various groups of rural and marginalized women in Tamil Nadu to understand their perspectives and concerns on abortion, especially MA. Nearly a decade after mifepristone was approved for abortion in India, most study participants had never heard of MA. When they learned of the method, most preferred it over other methods of abortion. The women also had questions and concerns about the method and recommendations on how services should be provided. Their definition of a "safe abortion" included criteria beyond medical safety. They placed a high priority on "social safety," including confidentiality and privacy. In their view, factors affecting access to safe abortion and choice of provider included cost, assurance of secrecy, promptness of service provision, and absence of provider gatekeeping and provider-imposed conditions for receiving services. Women's preference for MA shows the potential of this technology to address the problem of unsafe abortion in India. Women need better access to information and services to realize this potential, however. Women's preferences regarding information dissemination and service provision need to be taken into account if policies and programs are to be truly responsive to the needs of marginalized women. Copyright © 2012. Published by Elsevier Ireland Ltd.

  17. The Strategic Nature of Compliance

    DEFF Research Database (Denmark)

    König, Thomas; Mäder, Lars Kai

    2014-01-01

    by the anticipated enforcement decision of the monitoring agency and whether this agency is responsive to the probability of enforcement success and the potential sanctioning costs produced by noncomplying implementers. Compared to other monitoring systems, the centralized monitoring system of the European Union (EU......This compliance study models correct and timely implementation of policies in a multilevel system as a strategic game between a central monitoring agency and multiple implementers and evaluates statistically the empirical implications of this model. We test whether compliance is determined......) is praised for exemplary effectiveness, but our findings reveal that the monitoring agency refrains from enforcing compliance when the probability of success is low, and the sanctioning costs are high. This results in a compliance deficit, even though the selective enforcement activities of the monitoring...

  18. Pharmacy Malpractice: The rate and prevalence of dispensing high-risk prescription-only medications at community pharmacies in Saudi Arabia.

    Science.gov (United States)

    Alshammari, Thamir M; Alhindi, Salman A; Alrashdi, Ahmed M; Benmerzouga, Imaan; Aljofan, Mohamad

    2017-07-01

    To assess the compliance of community pharmacies with the regulations that prohibit the dispensing of prescription-only medications in the absence of a physician prescription in Saudi Arabia. A cross-sectional study was conducted in the period between October 2014 and January 2015. A list of 10 prescription-only medications were selected to be studied. 150 community pharmacies were visited across 6 major regions in Saudi Arabia to assess the prevalence of non-compliance among community pharmacies. Pharmacies were selected in random and researchers (disguised as patients) requested to purchase prescription-only medications in the absence of a prescription. Not all medications were purchased at once. Data were recorded per pharmacy, where pharmacies that approved dispense of the selected drug were scored as non-compliant and the pharmacies that rejected dispense of the selected drug were scored as compliant. Compliance rate was calculated per region per drug. Pharmacies based in governmental hospitals were visited in parallel. A total of 20 were visited. Data and statistical analysis were performed using Statistical Analyses Software (SAS 9.3). A total of 150 pharmacies were visited over a period of 3 months. On average, the percent approved dispense of prescription-only drugs across 6 regions in Saudi Arabia is 63% and the percent rejected dispense is 37% representing a significant non-compliance rate regarding the selected list of medications in this study. The frequency of dispense per medication across 6 major regions in Saudi Arabia is as follows: Isosorbide dinitrate (86%), Enoxaparin (82%), nitroglycerin (74%), Propranolol (73%), Verapamil (70%), Warfarin (65%), Methyldopa (64%), Ciprofloxacin (57%) and Codeine (4%). Non-compliance of community pharmacies with the law of pharmaceutical practice is at an alarming rate in the Kingdom of Saudi Arabia and authoritative figures must intervene to impede and combat such activities .

  19. Directory of certificates of compliance for radioactive materials packages. Certificates of compliance

    International Nuclear Information System (INIS)

    1979-10-01

    This volume contains all Certificates of Compliance for radioactive material packages effective September 14, 1979. Purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance number is included at the back of each volume of the directory

  20. Duloxetine compliance and its association with healthcare costs among patients with diabetic peripheral neuropathic pain.

    Science.gov (United States)

    Wu, N; Chen, S; Boulanger, L; Fraser, K; Bledsoe, S L; Zhao, Y

    2009-09-01

    Duloxetine is approved to treat diabetic peripheral neuropathic pain (DPNP) in the US. The study objective was to examine the predictors of duloxetine compliance, and its association with healthcare costs among DPNP patients. The study used administrative claims databases to identify non-depressed DPNP patients with a duloxetine prescription dispensed between October 1, 2004 and December 31, 2006. Two cohorts of patients were constructed based on compliance to duloxetine therapy over 1-year follow-up with high compliance defined as a medication possession ratio (MPR) > or =0.80. All-cause, diabetes-, and DPNP-related healthcare costs during 1-year follow-up were estimated. Logistic regressions were performed to examine how average daily dose (ADD) of duloxetine and other factors may influence compliance. Multivariate regressions were estimated to examine the association between compliance and healthcare costs. The study included 1,380 commercially insured (mean age 55 years) and 974 patients with employer-sponsored Medicare supplemental insurance (mean age 75 years). In both populations, patients with an ADD >30 mg were more likely to be compliant with the therapy compared with those with an ADD of compliance patients had greater all-cause ($5,334, pcosts ($3,414, pcompliance patients, with the biggest difference from inpatient costs (all-cause: $7,508; diabetes-related: $3,785, all pcosts were not significant. DPNP patients with a higher ADD of duloxetine over a 1-year follow-up period were more compliant with the therapy. Duloxetine patients with high compliance were also associated with lower healthcare costs. Due to the use of a retrospective cohort design on administrative claims database, limitations of this analysis include a lack of formal diagnostic testing of patients, and inability to infer causality or measure factors such as DPNP severity that are not captured in such database.

  1. [Compliance with antismoking laws in official institutions].

    Science.gov (United States)

    Cordovilla, R; Barrueco, M; González Ruiz, J M; Hernández, M A; de Castro, J; Gómez, F

    1997-01-01

    The prevention of nicotine addiction involves a wide range of measures, including writing laws to preserve public health by protecting nonsmokers from smoke and discouraging smokers from consumption. Also important are campaigns to educate both parties (smokers and nonsmokers) about the negative effects of tobacco. The main antismoking law in Spain is the Health and Consumer Ministry's Royal Decree 192/1988 limiting the sale and use of tobacco with the aim of protecting public health. Other regulations have since been enacted by public administrations to complement that law. Research finding published in recent years have been the basis for major legal changes leading in two directions; toward standardizing laws existing in different countries and toward increasing restrictions on the advertising and sale of tobacco. Various scientific and social groups have demanded that current laws be made stricter. Little has been done, however, to assess the degree of vigilance and compliance, and consequently the efficacy, of current legislation. The aim of this study was to determine the level of compliance with the law in governmental institutions in Salamanca. We visited 30 centers and saw that while notices prohibiting smoking were visible in 80%, the number of smokers was high: 43% among workers (none of whom was in educational or medical centers) and 37% among the public. No posters warning of the dangers of tobacco were seen in any of the centers visited. It appears necessary to further restrict the sale and use of tobacco in public places, to enforce compliance with existing regulations and to increase the amount of information on the toxic effects of tobacco in order to gain the cooperation of both smokers and nonsmokers toward achieving smoke-free environments.

  2. 42 CFR 124.503 - Compliance level.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Compliance level. 124.503 Section 124.503 Public... Unable To Pay § 124.503 Compliance level. (a) Annual compliance level. Subject to the provisions of this... persons unable to pay if it provides for the fiscal year uncompensated services at a level not less than...

  3. Perceptions of stigma among medical and nursing students and tuberculosis and diabetes patients at a teaching hospital in southern India.

    Science.gov (United States)

    Vaz, Manjulika; Travasso, Sandra M; Vaz, Mario

    2016-01-01

    Stigma has a significant impact on the diagnosis of a variety of illnesses, patients' compliance with treatment and their recovery from these diseases. However, the Indian medical and nursing curriculum has given relatively little attention to recognising and addressing the issue of stigma. This study compared the perception of stigma with respect to tuberculosis (TB) and diabetes mellitus (DM) among medical and nursing students to that among patients with these diseases. The Explanatory Model Interview Catalogue (EMIC) questionnaire was used for all patients and student groups. Focus group discussions were held with only the students to understand their concept of stigma and the challenges they face while addressing stigma, and to explore their role in addressing stigma. The data showed that patients with TB prefer not to disclose their illness, while DM is not perceived of as stigmatising by patients. As a group, medical and nursing students attached excessive stigma to patients with both DM and TB, and this may mean that medical professionals subconsciously do harm through their interactions with patients and the attitudes they project to society. The perceptions of stigma were linked to the patient's socioeconomic background, apart from the medical condition itself. The students recognised that they lacked the skills to understand and address stigma. We recommend that the subject of stigma be integrated into the curriculum of medical and nursing students.

  4. A new model to understand the career choice and practice location decisions of medical graduates.

    Science.gov (United States)

    Stagg, P; Greenhill, J; Worley, P S

    2009-01-01

    Australian medical education is increasingly influenced by rural workforce policy. Therefore, understanding the influences on medical graduates' practice location and specialty choice is crucial for medical educators and medical workforce planners. The South Australian Flinders University Parallel Rural Community Curriculum (PRCC) was funded by the Australian Government to help address the rural doctor workforce shortage. The PRCC was the first community based medical education program in Australia to teach a full academic year of medicine in South Australian rural general practices. The aim of this research was to identify what factors influence the career choices of PRCC graduates. A retrospective survey of all contactable graduates of the PRCC was undertaken. Quantitative data were analysed using SPSS 14.0 for Windows. Qualitative data were entered into NVIVO 7 software for coding, and analysed using content analysis. Usable data were collected from 46 of the 86 contactable graduates (53%). More than half of the respondents (54%) reported being on a rural career path. A significant relationship exists between being on a rural career pathway and making the decision prior to or during medical school (p = 0.027), and between graduates in vocational training who are on an urban career path and making a decision on career specialty after graduation from medical school (p = .004). Graduates in a general practice vocational training program are more likely to be on a rural career pathway than graduates in a specialty other than general practice (p = .003). A key influence on graduates' practice location is geographic location prior to entering medical school. Key influences on graduates choosing a rural career pathway are: having a spouse/partner with a rural background; clinical teachers and mentors; the extended rural based undergraduate learning experience; and a specialty preference for general practice. A lack of rural based internships and specialist training

  5. Determinants of compliance with anti-vectorial protective measures among non-immune travellers during missions to tropical Africa

    Directory of Open Access Journals (Sweden)

    Briolant Sébastien

    2011-08-01

    Full Text Available Abstract Background The effectiveness of anti-vectorial malaria protective measures in travellers and expatriates is hampered by incorrect compliance. The objective of the present study was to identify the determinants of compliance with anti-vectorial protective measures (AVPMs in this population that is particularly at risk because of their lack of immunity. Methods Compliance with wearing long clothing, sleeping under insecticide-impregnated bed nets (IIBNs and using insect repellent was estimated and analysed by questionnaires administered to 2,205 French military travellers from 20 groups before and after short-term missions (approximately four months in six tropical African countries (Senegal, Ivory Coast, Chad, Central African Republic, Gabon and Djibouti. For each AVPM, the association of "correct compliance" with individual and collective variables was investigated using random-effect mixed logistic regression models to take into account the clustered design of the study. Results The correct compliance rates were 48.6%, 50.6% and 18.5% for wearing long clothing, sleeping under bed nets and using repellents, respectively. Depending on the AVPM, correct compliance was significantly associated with the following factors: country, older than 24 years of age, management responsibilities, the perception of a personal malaria risk greater than that of other travellers, the occurrence of life events, early bedtime (i.e., before midnight, the type of stay (field operation compared to training, the absence of medical history of malaria, the absence of previous travel in malaria-endemic areas and the absence of tobacco consumption. There was no competition between compliance with the different AVPMs or between compliance with any AVPM and malaria chemoprophylaxis. Conclusion Interventions aimed at improving compliance with AVPMs should target young people without management responsibilities who are scheduled for non-operational activities in

  6. A randomised crossover trial of minimising medical terminology in secondary care correspondence in patients with chronic health conditions: impact on understanding and patient reported outcomes.

    Science.gov (United States)

    Wernick, M; Hale, P; Anticich, N; Busch, S; Merriman, L; King, B; Pegg, T

    2016-05-01

    There is little existing research on the role that secondary care letters have in ensuring patient understanding of chronic health conditions. To determine whether minimising the use of medical terminology in medical correspondence improved patient understanding and anxiety/depression scores. A single-centre, non-blinded, randomised crossover design assessed health literacy, EQ-5D scores and the impact of the 'translated' letter on the doctor's professionalism, the patient's relationship with their general practitioner (GP) and their perceived impact on chronic disease management. Patients were crossed over between their 'translated' and original letter. Sixty patients were recruited. Use of a 'translated' letter reduced mean terms not understood from 7.78 to 1.76 (t(58) = 4.706, P medical terminology in medical correspondence significantly improved patient understanding and perception of their ability to manage their chronic health condition. Although there was no impact on EQ-5D depression/anxiety scores, overwhelming patient preference for the 'translated' letter indicates a need for minimisation of medical terminology in medical correspondence for patients with chronic health conditions. © 2016 Royal Australasian College of Physicians.

  7. Compliance and Effectiveness of WHO Surgical Safety Check list: A JPMC Audit

    OpenAIRE

    Anwer, Mariyah; Manzoor, Shahneela; Muneer, Nadeem; Qureshi, Shamim

    2016-01-01

    Objective: To assess World Health Organization (WHO) Surgical Safety Checklist (SSC), compliance and its effectiveness in reducing complications and final outcome of patients. Methods: This was a prospective study done in Department of General Surgery (Ward 02), Jinnah Postgraduate Medical Centre (JPMC), Karachi. The study included Total 3638 patients who underwent surgical procedure in elective theatre in four years from November 2011 to October 2015 since the SSC was included as part of his...

  8. WOSMIP II- Workshop on Signatures of Medical and Industrial Isotope Production

    Energy Technology Data Exchange (ETDEWEB)

    Matthews, Murray; Achim, Pascal; Auer, M.; Bell, Randy; Bowyer, Ted W.; Braekers, Damien; Bradley, Ed; Briyatmoko, Budi; Berglund, Helena; Camps, Johan; Carranza, Eduardo C.; Carty, Fitz; DeCaire, Richard; Deconninck, Benoit; DeGeer, Lars E.; Druce, Michael; Friese, Judah I.; Hague, Robert; Hoffman, Ian; Khrustalev, Kirill; Lucas, John C.; Mattassi, G.; Mattila, Aleski; Nava, Elisabetta; Nikkinin, Mika; Papastefanou, Constantin; Piefer, Gregory R.; Quintana, Eduardo; Ross, Ole; Rotty, Michel; Sabzian, Mohammad; Saey, Paul R.; Sameh, A. A.; Safari, M.; Schoppner, Michael; Siebert, Petra; Unger, Klaus K.; Vargas, Albert

    2011-11-01

    Medical and industrial fadioisotopes are fundamental tools used in science, medicine and industry with an ever expanding usage in medical practice where their availability is vital. Very sensitive environmental radionuclide monitoring networks have been developed for nuclear-security-related monitoring [particularly Comprehensive Test-Ban-Treaty (CTBT) compliance verification] and are now operational.

  9. GENDER AND ETHNICITY DIFFERENCES IN TAX COMPLIANCE

    Directory of Open Access Journals (Sweden)

    Jeyapalan Kasipillai

    2006-01-01

    Full Text Available The purpose of this study is to investigate whether gender and ethnicity differences occur in relation to tax compliance attitude and behavior. Prior studies on tax compliance have focused little on gender as a predictor of compliance. In Malaysia, ethnic background of a taxpayer could be a major determinant of tax compliance. A personal interview approach is used to obtain information from taxpayers in urban towns. A t-test suggests that males and females were found to have similar compliant attitude. As for ethnicity, asimilar result was observed. Results of a regression analysis indicate that gender, academic qualification, and the person preparing tax return were statistically significant as determinants of non-compliant attitude. In terms of compliant behavior, a regression analysis revealed that "attitude towards non-compliance" and "receipt of cash income" were two significant explanatory variables of tax non-compliance behavior of understating income knowingly. The findings of this study are useful for policyimplications in identifying groups that require additional attention to increase voluntary tax compliance.

  10. Compliance with physical exercise

    DEFF Research Database (Denmark)

    Gram, Anne Sofie; Bønnelycke, Julie; Rosenkilde Larsen, Mads

    2014-01-01

    Aims: Sixty-one healthy, sedentary, moderately overweight young men participated in a randomised controlled trial to examine the effects of two different doses of endurance exercise on health behaviour and exercise compliance. Methods: Participants were randomised to a sedentary control group......), a post hoc thematic analysis was conducted to connect qualitative and quantitative data in a joint analysis. Results: Of the subjects interviewed, exercise compliance expressed as 95% CI was [96.8; 103%] in the MOD group and [82.9; 99.6%] in the HIGH group. The different doses of daily exercise equally...... or quantitative methodology alone. The preconditions of the TBP were fulfilled, and it represents a methodological model to explain the high degree of compliance and motivation to exercise....

  11. Monitoring Compliance to Promote Quality Assurance: Development of a Mental Health Clinical Chart Audit Tool in Belize, 2013.

    Science.gov (United States)

    Winer, Rachel A; Bennett, Eleanor; Murillo, Illouise; Schuetz-Mueller, Jan; Katz, Craig L

    2015-09-01

    Belize trained psychiatric nurse practitioners (PNPs) in the early 1990s to provide mental health services throughout the country. Despite overwhelming success, the program is limited by lack of monitoring, evaluation, and surveillance. To promote quality assurance, we developed a chart audit tool to monitor mental healthcare delivery compliance for initial psychiatric assessment notes completed by PNPs. After reviewing the Belize Health Information System electronic medical record system, we developed a clinical audit tool to capture 20 essential components for initial assessment clinical notes. The audit tool was then piloted for initial assessment notes completed during July through September of 2013. One hundred and thirty-four initial psychiatric interviews were audited. The average chart score among all PNPs was 9.57, ranging from 3 to 15. Twenty-three charts-or 17.2%-had a score of 14 or higher and met a 70% compliance benchmark goal. Among indicators most frequently omitted included labs ordered and named (15.7%) and psychiatric diagnosis (21.6%). Explicit statement of medications initiated with dose and frequency occurred in 47.0% of charts. Our findings provide direction for training and improvement, such as emphasizing the importance of naming labs ordered, medications and doses prescribed, and psychiatric diagnoses in initial assessment clinical notes. We hope this initial assessment helps enhance mental health delivery compliance by prompting creation of BHIS templates, development of audits tools for revisit follow-up visits, and establishment of corrective actions for low-scoring practitioners. These efforts may serve as a model for implementing quality assurance programming in other low resource settings.

  12. Insights and models from medical anthropology for understanding the healing activity of the Historical Jesus

    Directory of Open Access Journals (Sweden)

    John J. Pilch

    1995-12-01

    Full Text Available This essay sketches a basic introdution to medical anthropology as a key to understanding and interpreting  the healing activity of the historical Jesus described in the gospels. It presents select literature, leading experts, fundamental concepts, and insights and models of special value to biblical specialists. Only a cross-cultural discipline like medical anthropology allows the investigator to  interpret texts and events from other cultures with respect for their distinctive cultural contexts in order to draw more appropriate conclusions and applications in other cultures. Applications to biblical texts are not included in this essay but may be found in other articles published by the author and listed in the bibliography.

  13. State regulatory issues in acid rain compliance

    International Nuclear Information System (INIS)

    Solomon, B.D.; Brick, S.

    1992-01-01

    This article discusses the results of a US EPA workshop for state regulators and commission staff on acid rain compliance concerns. The topics of the article include the results of market-based emissions control, how emissions trading is expected to reduce emissions, public utility commissions approval of compliance plans, the purposes of the workshop, market information, accounting issues, regulatory process and utility planning, multi-state compliance planning, and relationship to other compliance issues

  14. Diagnostic information in compliance checking

    NARCIS (Netherlands)

    Ramezani Taghiabadi, E.; Fahland, D.; Aalst, van der W.M.P.

    2012-01-01

    Compliance checking is gaining importance as today's organizations need to show that operational processes are executed in a controlled manner while satisfying predefined (legal) requirements. Deviations may be costly and expose the organization to severe risks. Compliance checking is of growing

  15. SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

    International Nuclear Information System (INIS)

    Weir, V; Zhang, J

    2014-01-01

    Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medical physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department

  16. SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

    Energy Technology Data Exchange (ETDEWEB)

    Weir, V [Baylor Health Care System, Dallas, TX (United States); Zhang, J [University of Kentucky, Lexington, KY (United States)

    2014-06-01

    Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medical physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department.

  17. What are the factors predictive of hysterosalpingogram compliance after female sterilization by the Essure procedure in a publicly insured population?

    Science.gov (United States)

    Howard, David L; Wall, Jeffrey; Strickland, Julie L

    2013-12-01

    To determine what factors are predictive of post-Essure hysterosalpingogram (HSG) compliance. We conducted a retrospective chart review of all patients who underwent the Essure procedure at the two campuses of the Truman Medical Center, Kansas City, Missouri, from January 1, 2005 through December 31, 2010. Our study population consisted primarily of women who were publicly insured (89.0 %) and unmarried (76.7 %). Of 132 patients referred for HSG, 70 (53.0 %) complied. In adjusted analyses women 35 years and older had an almost fourfold higher odds of HSG compliance (OR = 3.72, 95 % CI 1.35-10.23) and women with 3 or more living children had a 64 % lower odds of HSG compliance (OR = 0.36, 95 % CI 0.16-0.82). Women younger than 35 who had 3 or more children had the lowest compliance rate (36.4 %) suggesting an interaction between age and parity. Women undergoing the Essure procedure at the campus with a dedicated protocol to ensure compliance had an almost fourfold higher odds of HSG compliance (OR = 3.67, 95 % CI 1.01-13.40). In a population consisting largely of publicly insured, unmarried women, several factors are predictive of post-Essure HSG compliance. These include age, parity and the presence or absence of an institutional protocol to keep track of patients after their Essure procedure.

  18. Identifying the Average Causal Mediation Effects with Multiple Mediators in the Presence of Treatment Non-Compliance

    Science.gov (United States)

    Park, Soojin

    2015-01-01

    Identifying the causal mechanisms is becoming more essential in social and medical sciences. In the presence of treatment non-compliance, the Intent-To-Treated effect (hereafter, ITT effect) is identified as long as the treatment is randomized (Angrist et al., 1996). However, the mediated portion of effect is not identified without additional…

  19. On the impact of medical device regulations on software architecture

    DEFF Research Database (Denmark)

    Hansen, Klaus Marius; Manikas, Konstantinos

    2016-01-01

    Compliance to regulations and regulatory approval are requirements for many medical device software systems. In this paper, we investigate the implications of medical device software regulations to the design of software systems. We do so by focusing on the American and European regulatory author...... of the device. Moreover, we review software modularity in the implementation of software medical device and propose a set of preliminary principles for architectural design of software medical device based on a set of constrains identified from the reviewed regulations....

  20. Johnson Space Center Health and Medical Technical Authority

    Science.gov (United States)

    Fogarty, Jennifer A.

    2010-01-01

    1.HMTA responsibilities: a) Assure program/project compliance with Agency health and medical requirements at identified key decision points. b) Certify that programs/projects comply with Agency health and medical requirements prior to spaceflight missions. c) Assure technical excellence. 2. Designation of applicable NASA Centers for HMTA implementation and Chief Medical Officer (CMO) appointment. 3. Center CMO responsible for HMTA implementation for programs and projects at the center. JSC HMTA captured in "JSC HMTA Implementation Plan". 4. Establishes specifics of dissenting opinion process consistent with NASA procedural requirements.

  1. Investigating compliance with SME-friendly procurement policy

    OpenAIRE

    Flynn, Anthony

    2016-01-01

    This study investigates compliance with SME-friendly policy in public procurement. Two research questions guide the investigation. The first is the extent to which policy is being complied with. The results, which are based on 349 public buyer survey responses, reveal compliance to be moderate; indicated by a mean score of 14.54 out of 22 on the compliance index. The second question concerns the impact of institutional forces on policy compliance. A predictive model informed by institutional ...

  2. "Understanding" medical school curriculum content using KnowledgeMap.

    Science.gov (United States)

    Denny, Joshua C; Smithers, Jeffrey D; Miller, Randolph A; Spickard, Anderson

    2003-01-01

    To describe the development and evaluation of computational tools to identify concepts within medical curricular documents, using information derived from the National Library of Medicine's Unified Medical Language System (UMLS). The long-term goal of the KnowledgeMap (KM) project is to provide faculty and students with an improved ability to develop, review, and integrate components of the medical school curriculum. The KM concept identifier uses lexical resources partially derived from the UMLS (SPECIALIST lexicon and Metathesaurus), heuristic language processing techniques, and an empirical scoring algorithm. KM differentiates among potentially matching Metathesaurus concepts within a source document. The authors manually identified important "gold standard" biomedical concepts within selected medical school full-content lecture documents and used these documents to compare KM concept recognition with that of a known state-of-the-art "standard"-the National Library of Medicine's MetaMap program. The number of "gold standard" concepts in each lecture document identified by either KM or MetaMap, and the cause of each failure or relative success in a random subset of documents. For 4,281 "gold standard" concepts, MetaMap matched 78% and KM 82%. Precision for "gold standard" concepts was 85% for MetaMap and 89% for KM. The heuristics of KM accurately matched acronyms, concepts underspecified in the document, and ambiguous matches. The most frequent cause of matching failures was absence of target concepts from the UMLS Metathesaurus. The prototypic KM system provided an encouraging rate of concept extraction for representative medical curricular texts. Future versions of KM should be evaluated for their ability to allow administrators, lecturers, and students to navigate through the medical curriculum to locate redundancies, find interrelated information, and identify omissions. In addition, the ability of KM to meet specific, personal information needs should be

  3. A Theory of Compliance with Minimum Wage Law

    OpenAIRE

    Asongu Simplice; Jellal Mohamed

    2014-01-01

    Purpose – In this paper, we introduce firm heterogeneity in the context of a model of non-compliance with minimum wage legislation. Design/methodology/approach – Theoretical modeling under government compliance policy and wages & employment under non compliance. Findings – The introduction of heterogeneity in the ease with which firms can be monitored for non compliance allows us to show that non-compliance will persist in sectors which are relatively difficult to monitor, despite the governm...

  4. Developing the Medication Reminder Mobile Application "Seeb".

    Science.gov (United States)

    Saghaeiannejad-Isfahani, Sakineh; Ehteshami, Asghar; Savari, Ebtesam; Samimi, Ali

    2017-06-01

    Today, the structure of comprehensive health care emphasizes self-care more than therapy. Medication therapy is a strong instrument for therapy received through the health setting, especially in medication area. Error in medication administration has produced different problems and they cost billions of dollars every year. Regarding mobile phone extensions, we developed a local medication reminder mobile application called "Seeb" as a suitable solution for decreasing medication errors for Iranians. We conducted a mixed methods study in three Phases: 1) Comparative study of existing mobile applications; 2) developed its object-oriented model; 3) Developed the initial version of "Seeb" that was approved for production. This application was designed for the appropriate medication administration including time and dosages through: recording patient and medication data; scheduling patients' medication; and reporting medication administration on progress. "Seeb" has been designed in compliance with Iranian health information technologists and pharmacists requirements. It is expected to reduce medication error and improve patient adherence to medical prescriptions.

  5. A first step toward understanding best practices in leadership training in undergraduate medical education: a systematic review.

    Science.gov (United States)

    Webb, Allison M B; Tsipis, Nicholas E; McClellan, Taylor R; McNeil, Michael J; Xu, MengMeng; Doty, Joseph P; Taylor, Dean C

    2014-11-01

    To characterize leadership curricula in undergraduate medical education as a first step toward understanding best practices in leadership education. The authors systematically searched the PubMed, Education Resources Information Center, Academic Search Complete, and Education Full Text databases for peer-reviewed English-language articles published 1980-2014 describing curricula with interventions to teach medical students leadership skills. They characterized educational settings, curricular format, and learner and instructor types. They assessed effectiveness and quality of evidence using five-point scales adapted from Kirkpatrick's four-level training evaluation model (scale: 0-4) and a Best Evidence Medical Education guide (scale: 1-5), respectively. They classified leadership skills taught into the five Medical Leadership Competency Framework (MLCF) domains. Twenty articles describing 24 curricula met inclusion criteria. The majority of curricula (17; 71%) were longitudinal, delivered over periods of one semester to four years. The most common setting was the classroom (12; 50%). Curricula were frequently provided to both preclinical and clinical students (11; 46%); many (9; 28%) employed clinical faculty as instructors. The majority (19; 79%) addressed at least three MLCF domains; most common were working with others (21; 88%) and managing services (18; 75%). The median effectiveness score was 1.5, and the median quality of evidence score was 2. Most studies did not demonstrate changes in student behavior or quantifiable results. Aligning leadership curricula with competency models, such as the MLCF, would create opportunities to standardize evaluation of outcomes, leading to better measurement of student competency and a better understanding of best practices.

  6. GENDER AND ETHNICITY DIFFERENCES IN TAX COMPLIANCE

    OpenAIRE

    Jeyapalan Kasipillai; Hijattulah Abdul Jabbar

    2006-01-01

    The purpose of this study is to investigate whether gender and ethnicity differences occur in relation to tax compliance attitude and behavior. Prior studies on tax compliance have focused little on gender as a predictor of compliance. In Malaysia, ethnic background of a taxpayer could be a major determinant of tax compliance. A personal interview approach is used to obtain information from taxpayers in urban towns. A t-test suggests that males and females were found to have similar compliant...

  7. Type B Package Radioactive Material Contents Compliance

    International Nuclear Information System (INIS)

    HENSEL, STEVE

    2006-01-01

    Implementation of packaging and transportation requirements can be subdivided into three categories; contents compliance, packaging closure, and transportation or logistical compliance. This paper addresses the area of contents compliance within the context of regulations, DOE Orders, and appropriate standards. Common practices and current pitfalls are also discussed

  8. Do Pregnant Women Report Use of Dispensed Medications?

    DEFF Research Database (Denmark)

    Olesen, Charlotte; Søndergaard, Charlotte; Thrane, Nana

    2001-01-01

    Surveillance of drug safety in pregnancy often draws on administrative prescription registries. Noncompliance in the use of prescribed medication may be frequent among pregnant women owing to their fear of fetotoxic side effects. To estimate compliance in the use of prescription drugs dispensed...... during pregnancy, we compared prescription data from the North Jutland Prescription Database with information on drug use provided by pregnant women to the Danish National Birth Cohort (DNBC), which is a health interview survey. We used the North Jutland Prescription Database to identify all prescription...... drugs dispensed during pregnancy for the 2,041 women who were enrolled in the DNBC in the County of North Jutland, Denmark. Compliance was defined as the probability of reporting drug use in DNBC after purchasing a dispensed prescription drug. The overall compliance to drugs purchased within 120 days...

  9. Environmental Compliance by Firms in the Manufacturing Sector in Mexico

    OpenAIRE

    Lata Gangadharan

    2003-01-01

    To date, little empirical evidence exists to help regulators understand why some firms comply even when there is little financial incentive to do so and others continually violate environmental regulations. This paper examines data on compliance with environmental regulations within the manufacturing sector in Mexico. The probability of complying depends, among other factors, on the kind of management practices of the firm and the level of environmental training. Some firms in the manufacturi...

  10. Mobile Source Emissions Regulatory Compliance Data

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Engine and Vehicle Compliance Certification and Fuel Economy Inventory contains measured emissions and fuel economy compliance information for all types of...

  11. I. INTRODUCTION: UNDERSTANDING MEDICINES AND MEDICAL INTERVENTIONS.

    Science.gov (United States)

    Lockhart, Kristi L; Keil, Frank C

    2018-06-01

    We live in an increasingly pharmacological and medical world, where children and adults frequently encounter alleged treatments for an enormous range of illnesses. How do we come to understand what heals and why? Here, 15 studies explore how 1,414 children (ages 5-11) and 882 adults construe the efficacies of different kinds of cures. Developmental patterns in folk physics, psychology, and biology lead to predictions about which expectations about cures will remain relatively constant across development and which will change. With respect to stability, we find that even young school children (ages 5-7) distinguish between physical and psychological disorders and the treatments most effective for each. In contrast, young children reason differently about temporal properties associated with cures. They often judge that dramatic departures from prescribed schedules will continue to be effective. Young children are also less likely than older ages to differentiate between the treatment needs of acute versus chronic disorders. Young children see medicines as agent-like entities that migrate only to afflicted regions while having "cure-all" properties, views that help explain their difficulties grasping side effects. They also differ from older children and adults by judging pain and effort as reducing, instead of enhancing, a treatment's power. Finally, across all studies, optimism about treatment efficacy declines with age. Taken together, these studies show major developmental changes in how children envision the ways medicines work in the body. Moreover, these findings link to broader patterns in cognitive development and have implications for how medicines should be explained to children. © 2018 The Society for Research in Child Development, Inc.

  12. The Mental Health Care Act: Stakeholder compliance with respect to Section 40 of the Act.

    Directory of Open Access Journals (Sweden)

    Greg Wayne Jonsson

    2009-06-01

    Full Text Available Objective. To determine compliance with Section 40 (1-3 of the Mental Health Care Act (MHCA No 17 of 2002, viz. handing over custody by the South African Police Service (SAPS of suspected mentally ill patients to medical services at Chris Hani Baragwanath Hospital (CHBH. Methods. The study was a retrospective record review of patients who were 18 years and older, referred by SAPS to CHBH. In accordance with Section 40 of the MHCA, a MHCA form 22 is completed when suspected mentally ill patients are handed over by SAPS to the medical services. MHCA forms 22 that were completed during the period July 2007 to December 2007 were obtained from hospital records and analysed to determine the compliance of SAPS and medical practitioners in completing them. Results. During the study period, 708 of the 718 patients handed over by SAPS to the Emergency Department of CHBH were entered on MHCA forms 22. SAPS officials had correctly completed 86% of the forms, whereas the medical practitioners had only correctly completed 9.9% of the forms. Of the 718 patients handed over by SAPS, 319 (44% were discharged for outpatient care. Conclusion. The findings of this study suggest that not all parties fully comply with Section 40 of the Mental Health Care Act No 17 of 2002. We suggest that the situation can be improved by training of all parties; amendments to the MHCA form 22; partnership between mental health care practitioners and members of SAPS; and combining resources towards implementing a crisis intervention model similar to that in other countries.

  13. Attitudes, understanding, and concerns regarding medical research amongst Egyptians: A qualitative pilot study

    Directory of Open Access Journals (Sweden)

    Raafat May

    2007-08-01

    Full Text Available Abstract Background Medical research must involve the participation of human subjects. Knowledge of patients' perspectives and concerns with their involvement in research would enhance recruitment efforts, improve the informed consent process, and enhance the overall trust between patients and investigators. Several studies have examined the views of patients from Western countries. There is limited empirical research involving the perspectives of individuals from developing countries. The purpose of this study is to examine the attitudes of Egyptian individuals toward medical research. Such information would help clarify the type and extent of concerns regarding research participation of individuals from cultural, economic, and political backgrounds that differ from those in developed countries. Methods We conducted semi-structured interviews with 15 Egyptian individuals recruited from the outpatient settings (public and private at Ain Shams University in Cairo, Egypt. Interviews were taped, transcribed, and translated. Thematic analysis followed. Results All individuals valued the importance of medical research; however most would not participate in research that involved more than minimal risk. Individuals were comfortable with studies involving surveys and blood sampling, but many viewed drug trials as being too risky. All participants valued the concept of informed consent, as they thought that their permission to be in a research study was paramount. Many participants had discomfort with or difficulty in the understanding several research concepts: randomization, double-blind, and clinical equipoise. Trust in the physicians performing research was important in deciding to participate in clinical research. The small sample size and the selection bias associated with obtaining information from only those who agreed to participate in a research study represent limitations in this study. Conclusion Overall, individuals in our sample recognize

  14. Understanding medical travel from a source country perspective: a cross sectional study of the experiences of medical travelers from the Maldives.

    Science.gov (United States)

    Suzana, Mariyam; Walls, Helen; Smith, Richard; Hanefeld, Johanna

    2018-06-19

    The resolution adopted in 2006 by the World Health Organization on international trade and health urges Member States to understand the implications of international trade and trade agreements for health and to address any challenges arising through policies and regulations. The government of Maldives is an importer of health services (with outgoing medical travelers), through offering a comprehensive universal health care package for its people that includes subsidized treatment abroad for services unavailable in the country. By the end of the first year of the scheme approximately US$11.6 m had been spent by the government of Maldives to treat patients abroad. In this study, affordability, continuity and quality of this care were assessed from the perspective of the medical traveler to provide recommendations for safer and more cost effective medical travel policy. Despite universal health care, a substantial proportion of Maldivian travelers have not accessed the government subsidy, and a third reported not having sufficient funds for the treatment episode abroad. Among the five most visited hospitals in this study, none were JCI accredited at the time of the study period and only three from India had undergone the National Accreditation Board for Hospitals (NABH) in India. Satisfaction with treatment received was high amongst travelers but concern for the continuity of care was very high, and more than a third of the patients had experienced complications arising from the treatment overseas. Source countries can use their bargaining power in the trade of health services to offer a more comprehensive package for medical travelers. Source countries with largely public funded health systems need to ensure that medical travel is truly affordable and universal, with measures for quality control such as the use of accredited foreign hospitals to make it safer and to impose measures that ensure the continuity of care for travelers.

  15. Does a summative portfolio foster the development of capabilities such as reflective practice and understanding ethics? An evaluation from two medical schools.

    Science.gov (United States)

    O'Sullivan, Anthony J; Howe, Amanda C; Miles, Susan; Harris, Peter; Hughes, Chris S; Jones, Philip; Scicluna, Helen; Leinster, Sam J

    2012-01-01

    Portfolios need to be evaluated to determine whether they encourage students to develop in capabilities such as reflective practice and ethical judgment. The aims of this study were (i) to determine whether preparing a portfolio helps promote students' development in a range of capabilities including understanding ethical and legal principles, reflective practice and effective communication, and (ii) to determine to what extent the format of the portfolio affected the outcome by comparing the experiences of students at two different medical schools. A questionnaire was designed to evaluate undergraduate medical students' experiences of completing a portfolio at two medical schools. A total of 526 (45% response rate) students answered the on-line questionnaire. Students from both medical schools gave the highest ranking for the portfolio as a trigger for reflective practice. 63% of students agreed their portfolio helped them develop reflective practice skills (p portfolios helped them understand ethical and legal principles whereas 29% disagreed (p portfolio helped them to develop effective communication. Students perceive portfolio preparation as an effective learning tool for the development of capabilities such as understanding ethical and legal principles and reflective practice, whereas other capabilities such as effective communication require complementary techniques and other modes of assessment.

  16. 40 CFR 73.35 - Compliance.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Compliance. 73.35 Section 73.35... ALLOWANCE SYSTEM Allowance Tracking System § 73.35 Compliance. (a) Allowance transfer deadline. No allowance... in § 73.34(a) of this part, the Administrator will deduct allowances for each source with excess...

  17. The creep compliance, the relaxation modulus and the complex compliance of linear viscoelastic, homogeneous, isotropic materials

    International Nuclear Information System (INIS)

    Wong, P.K.

    1989-01-01

    This paper reports on a study to obtain the creep compliance, the relaxation modulus and the complex compliance derived from the concept of mechanical resistance for the constitutive equation of a class of linear viscoelastic, homogeneous, isotropic materials

  18. Compliance of feed limits, does not mean compliance of food limits

    Directory of Open Access Journals (Sweden)

    van Raamsdonk LWD.

    2009-01-01

    Full Text Available The carry-over of contaminants from feed to animal food products is an important aspect of the animal production chain. For a proper containment, limits for feed as well food products are fixed for a series of chemicals, e.g. dioxins and dioxin-like PCBs, lead, cadmium, some chlorinated pesticides, and aflatoxin B1 (and its metabolite M1 in milk. The relationship between feed and food limits is an important issue. An ideal goal is to assure that compliance to a feed limits automatically results in compliance to food limits. In order to collect information about this relationship, several simulation models and a large database on transfer factors have been developed. An optimal choice between either a model or an application of data from the Transfer Database is based on both the knowledge level, and on the circumstances of the specific situation. To reach and validate such an optimal choice an Expert System Carry-Over is currently in development, containing four different modules: 1 the different calculation models and the Transfer Database, 2 a decision tree for choosing the optimal strategy, 3 data tables indicating knowledge levels of compound/animal/product parameters, and 4 supporting databases containing information on consumption and composition of daily diets, animal parameters, and amounts of (daily production. Calculations indicate that for dioxins compliance to feed levels does not necessarily mean that food limits are complied as well. Besides an estimation of the compliance to limits, the expert system is a tool for feed related risk assessments, and for planning of future research.

  19. Monitoring compliance with requirements during site characterization

    International Nuclear Information System (INIS)

    Herrington, C.C.; Jennetta, A.R.; Dobson, D.C.

    1991-01-01

    The question of when a program of Regulatory Compliance should be applied and what it should be applied to, when the subject of compliance is a High Level Radioactive Waste Repository, defies resolution by merely relating to past practices of licensees of the US Nuclear Regulatory Commission (NRC). NRC regulations governing the disposal of High Level Waste include interactions with the potential applicant (US DOE) during the pre-license application phase of the program when the basis for regulatory compliance is not well defined. To offset this shortcoming, the DOE will establish an expanded basis for regulatory compliance, keeping the NRC apprised of the basis as it develops. As a result, the preapplication activities of DOE will assume the added benefit of qualification to a suitable Regulatory Compliance monitoring and maintenance plan

  20. Respiratory mechanics to understand ARDS and guide mechanical ventilation.

    Science.gov (United States)

    Mauri, Tommaso; Lazzeri, Marta; Bellani, Giacomo; Zanella, Alberto; Grasselli, Giacomo

    2017-11-30

    As precision medicine is becoming a standard of care in selecting tailored rather than average treatments, physiological measurements might represent the first step in applying personalized therapy in the intensive care unit (ICU). A systematic assessment of respiratory mechanics in patients with the acute respiratory distress syndrome (ARDS) could represent a step in this direction, for two main reasons. Approach and Main results: On the one hand, respiratory mechanics are a powerful physiological method to understand the severity of this syndrome in each single patient. Decreased respiratory system compliance, for example, is associated with low end expiratory lung volume and more severe lung injury. On the other hand, respiratory mechanics might guide protective mechanical ventilation settings. Improved gravitationally dependent regional lung compliance could support the selection of positive end-expiratory pressure and maximize alveolar recruitment. Moreover, the association between driving airway pressure and mortality in ARDS patients potentially underlines the importance of sizing tidal volume on respiratory system compliance rather than on predicted body weight. The present review article aims to describe the main alterations of respiratory mechanics in ARDS as a potent bedside tool to understand severity and guide mechanical ventilation settings, thus representing a readily available clinical resource for ICU physicians.

  1. Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.

    Science.gov (United States)

    Lee, Yuna S H; Stone, Patricia W; Pogorzelska-Maziarz, Monika; Nembhard, Ingrid M

    Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals. The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs). A cross-sectional study of hospital medical-surgical ICUs in the United States was done. Data on work environment and bundle compliance were obtained from the Prevention of Nosocomial Infections and Cost-Effectiveness Refined Survey completed in 2011 by infection prevention directors, and data on ICU and hospital characteristics were obtained from the National Healthcare Safety Network. Factor and multilevel regression analyses were conducted. Reasonable workload and prioritization of quality were positively associated with maximal CLABSI bundle compliance. High-quality relationships, although a significant predictor when evaluated apart from workload and prioritization of quality, had no significant effect after accounting for these two factors. Aspects of the staff work environment are associated with maximal CLABSI bundle compliance in ICUs. Our results suggest that hospitals can foster improvement in ensuring maximal CLABSI bundle compliance-a crucial precursor to reducing CLABSI infection rates-by establishing reasonable workloads and prioritizing quality.

  2. ICF's Plant Compliance Assessment System

    International Nuclear Information System (INIS)

    Baker, S.M.

    1989-01-01

    Government and private industrial facilities must manage wastes that are both radioactive and (chemically) hazardous. Until recently, these mixed wastes have been managed under rules established under the Atomic Energy Act (AEA) and the Low-Level Waste Policy At, and rules that derive from environmental legislation have not been applied. Both sets of rules now apply to mixed wastes, creating situations in which significant changes to waste steams must be made in order to bring them into compliance with environmental regulations. The first step in bringing waste streams into compliance is to determine their status with respect to the newly-applicable regulations. This process of compliance assessment is difficult because requirements to minimize human exposure to radiation can conflict with requirements of environmental regulations, many regulations are potentially applicable, the regulations are changing rapidly, and because waste streams designed to operate under AEA rules frequently cannot be easily modified to incorporate the additional regulations. Modern personal computer (PC) tools are being developed to help regulatory analysts manage the large amounts of information required to asses the compliance status of complex process plants. This paper presents the Plant Compliance Assessment System (PCAS), which performs this function by relating a database containing references to regulatory requirements to databases created to describe relevant aspects of the facility to be assessed

  3. WE-E-12A-01: Medical Physics 1.0 to 2.0: MRI, Displays, Informatics

    International Nuclear Information System (INIS)

    Pickens, D; Flynn, M; Peck, D

    2014-01-01

    , effective implementation of that oversight has been challenging due to the number and extend of medical displays in use at a facility. The advent of color display and mobile displays has added additional challenges to the task of the medical physicist. This informatics display lecture first addresses the current display guidelines (the 1.0 paradigm) and further outlines the initiatives and prospects for color and mobile displays (the 2.0 paradigm). Informatics Management 1.0 to 2.0: Imaging informatics is part of every radiology practice today. Imaging informatics covers everything from the ordering of a study, through the data acquisition and processing, display and archiving, reporting of findings and the billing for the services performed. The standardization of the processes used to manage the information and methodologies to integrate these standards is being developed and advanced continuously. These developments are done in an open forum and imaging organizations and professionals all have a part in the process. In the Informatics Management presentation, the flow of information and the integration of the standards used in the processes will be reviewed. The role of radiologists and physicists in the process will be discussed. Current methods (the 1.0 paradigm) and evolving methods (the 2.0 paradigm) for validation of informatics systems function will also be discussed. Learning Objectives: Identify requirements for improving quality assurance and compliance tools for advanced and hybrid MRI systems. Identify the need for new quality assurance metrics and testing procedures for advanced systems. Identify new hardware systems and new procedures needed to evaluate MRI systems. Understand the components of current medical physics expectation for medical displays. Understand the role and prospect fo medical physics for color and mobile display devices. Understand different areas of imaging informatics and the methodology for developing informatics standards. Understand

  4. WE-E-12A-01: Medical Physics 1.0 to 2.0: MRI, Displays, Informatics

    Energy Technology Data Exchange (ETDEWEB)

    Pickens, D [Vanderbilt Medical Center, Nashville, TN (United States); Flynn, M; Peck, D [Henry Ford Health System, Detroit, MI (United States)

    2014-06-15

    , effective implementation of that oversight has been challenging due to the number and extend of medical displays in use at a facility. The advent of color display and mobile displays has added additional challenges to the task of the medical physicist. This informatics display lecture first addresses the current display guidelines (the 1.0 paradigm) and further outlines the initiatives and prospects for color and mobile displays (the 2.0 paradigm). Informatics Management 1.0 to 2.0: Imaging informatics is part of every radiology practice today. Imaging informatics covers everything from the ordering of a study, through the data acquisition and processing, display and archiving, reporting of findings and the billing for the services performed. The standardization of the processes used to manage the information and methodologies to integrate these standards is being developed and advanced continuously. These developments are done in an open forum and imaging organizations and professionals all have a part in the process. In the Informatics Management presentation, the flow of information and the integration of the standards used in the processes will be reviewed. The role of radiologists and physicists in the process will be discussed. Current methods (the 1.0 paradigm) and evolving methods (the 2.0 paradigm) for validation of informatics systems function will also be discussed. Learning Objectives: Identify requirements for improving quality assurance and compliance tools for advanced and hybrid MRI systems. Identify the need for new quality assurance metrics and testing procedures for advanced systems. Identify new hardware systems and new procedures needed to evaluate MRI systems. Understand the components of current medical physics expectation for medical displays. Understand the role and prospect fo medical physics for color and mobile display devices. Understand different areas of imaging informatics and the methodology for developing informatics standards. Understand

  5. 7 CFR 772.3 - Compliance.

    Science.gov (United States)

    2010-01-01

    ... SPECIAL PROGRAMS SERVICING MINOR PROGRAM LOANS § 772.3 Compliance. (a) Requirements. No Minor Program... parts 15d and 15e. (b) Reviews. In accordance with Title VI of the Civil Rights Act of 1964, the Agency will conduct a compliance review of all Minor Program borrowers, to determine if a borrower has...

  6. Estimation of the compliance of the human capacitance vessels using radionuclide plethysmography. Comparison of the compliance with the NYHA functional classification

    Energy Technology Data Exchange (ETDEWEB)

    Takatsu, Hisato; Gotoh, Kohshi; Suzuki, Takahiko and others

    1988-01-01

    Radionuclide (RN) plethysmography with Tc-99m RBC was performed in 32 patients with heart disease with the purpose of obtaining compliance of human capacitance vessels. When equilibrium was achieved, RN counts of the region of interest and venous pressure in the forearm were sequentially recorded when the vein of the upper arm was occluded with a cuff inflator. Based on the RN count-venous pressure curve, the specific compliance of the forearm vein and compliance of systemic venous system (SVS) were estimated. In the group of the NYHA functional classification I, which is recognized as hemodynamically ''normal'', the compliance of SVS was 129.8 +- 25.9 ml center dot mmHg/sup -1/ (mean +- SD; n = 9). In comparing the NYHA functional classification and the compliance of SVS, the compliance of SVS was significantly decreased for severer heart failure. Tongue administration of nitroglycerin (0.6 mg) significantly increased the compliance of SVS (p < 0.01). (Namekawa, K.).

  7. Measuring User Compliance and Cost Effectiveness of Safe Drinking Water Programs: A Cluster-Randomized Study of Household Ultraviolet Disinfection in Rural Mexico.

    Science.gov (United States)

    Reygadas, Fermín; Gruber, Joshua S; Dreizler, Lindsay; Nelson, Kara L; Ray, Isha

    2018-03-01

    Low adoption and compliance levels for household water treatment and safe storage (HWTS) technologies have made it challenging for these systems to achieve measurable health benefits in the developing world. User compliance remains an inconsistently defined and poorly understood feature of HWTS programs. In this article, we develop a comprehensive approach to understanding HWTS compliance. First, our Safe Drinking Water Compliance Framework disaggregates and measures the components of compliance from initial adoption of the HWTS to exclusive consumption of treated water. We apply this framework to an ultraviolet (UV)-based safe water system in a cluster-randomized controlled trial in rural Mexico. Second, we evaluate a no-frills (or "Basic") variant of the program as well as an improved (or "Enhanced") variant, to test if subtle changes in the user interface of HWTS programs could improve compliance. Finally, we perform a full-cost analysis of both variants to assess their cost effectiveness (CE) in achieving compliance. We define "compliance" strictly as the habit of consuming safe water. We find that compliance was significantly higher in the groups where the UV program variants were rolled out than in the control groups. The Enhanced variant performed better immediately postintervention than the Basic, but compliance (and thus CE) degraded with time such that no effective difference remained between the two versions of the program.

  8. Directory of certificates of compliance for radioactive materials packages: Certificates of compliance

    International Nuclear Information System (INIS)

    1987-11-01

    This directory contains a Summary Report of the US Nuclear Regulatory Commission's Certificates of Compliance (Volume 2) for Radioactive Material Packages effective October 1, 1987. This directory makes available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the back of Volume 2 of the directory. A listing by packaging types is included in the back of Volume 2

  9. Clean Air Markets - Compliance Query Wizard

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Compliance Query Wizard is part of a suite of Clean Air Markets-related tools that are accessible at http://ampd.epa.gov/ampd/. The Compliance module provides...

  10. A Review of Factors for Tax Compliance

    Directory of Open Access Journals (Sweden)

    Nicoleta BARBUTA-MISU

    2011-03-01

    Full Text Available The aim of this paper is to identify the variables of tax compliance analysed by researchers from various countries and adapting them to the Romanian conditions to create a model to include factors that influence decision of tax compliance. Tax compliance has been studied in economics by analysing the individual decision of a representative person between paying taxes and evading taxes. In the research of tax compliance have been done many empirical studies that emphasized the impact of a wide variety of potential determinants of voluntary compliance with individual income/profit tax filing and reporting obligations. The most important determinants identified are: economic factors as the level of income, audit probabilities, tax audit, tax rate, tax benefits, penalties, fines and other non-economic factors as attitudes toward taxes, personal, social and national norms, perceived fairness etc.

  11. Compliance With Injury Prevention Measures in Youth Pitchers: Survey of Coaches in Little League of Puerto Rico.

    Science.gov (United States)

    Pamias-Velázquez, Kristian J; Figueroa-Negrón, Mariam M; Tirado-Crespo, Janiliz; Mulero-Portela, Ana L

    2016-05-01

    Because of the problem of elbow and shoulder injuries in baseball pitchers between 9 and 14 years of age, the USA Baseball Medical & Safety Advisory Committee and the Department of Recreation and Sports in Puerto Rico developed injury prevention guidelines for pitchers. The purpose of this study was to determine the compliance of pitching coaches of 9- to 14-year-old Little League teams in Puerto Rico with the Administrative Order 2006-01 and the USA Baseball guidelines. (1) The coaches will have a satisfactory level of compliance with the Administrative Order as well as with the USA Baseball guidelines and (2) both the level of education of the coach as well as the years of experience will correlate with the level of compliance. Descriptive cross-sectional study. Level 5. A self-administered questionnaire was developed based on the Administrative Order and on the USA Baseball guidelines. A descriptive univariate analysis was conducted to determine the mean coach compliance with both guidelines. Pearson correlation coefficients were used to describe the correlation between the level of education and the years of experience of the coaches with the level of compliance. Thirty-five coaches (response rate, 78%) participated in the study. On average, the coaches complied with 70% of the Administrative Order and with 73% of the USA Baseball guidelines. No significant correlations were found. The coaches who participated in the study did not reflect a satisfactory level of compliance with the USA Baseball guidelines or with the Administrative Order. These findings emphasize the need for reinforcing compliance with the injury prevention guidelines and the need to provide resources and training to coaches to effectively prevent elbow and shoulder injuries in pitchers. © 2016 The Author(s).

  12. How Compliance Measures, Behavior Modification, and Continuous Quality Improvement Led to Routine HIV Screening in an Emergency Department in Brooklyn, New York.

    Science.gov (United States)

    Isaac, Jermel Kyri; Sanchez, Travis H; Brown, Emily H; Thompson, Gina; Sanchez, Christina; Fils-Aime, Stephany; Maria, Jose

    2016-01-01

    New York State adopted a new HIV testing law in 2010 requiring medical providers to offer an HIV test to all eligible patients aged 13-64 years during emergency room or ambulatory care visits. Since then, Wyckoff Heights Medical Center (WHMC) in Brooklyn, New York, began implementing routine HIV screening organization-wide using a compliance, behavior-modification, and continuous quality-improvement process. WHMC first implemented HIV screening in the emergency department (ED) and evaluated progress with the following monthly indicators: HIV tests offered, HIV tests accepted, HIV tests ordered (starting in December 2013), HIV tests administered, positive HIV tests, and linkage to HIV care. Compliance with the delivery of HIV testing was determined by the proportion of patients who, after accepting a test, received one. During August 2013 through July 2014, of 57,852 eligible patients seen in the WHMC ED, a total of 31,423 (54.3%) were offered an HIV test. Of those, 8,229 (26.2%) patients accepted a test. Of those, 6,114 (74.3%) underwent a test. A total of 26 of the 6,114 patients tested (0.4%) had a positive test, and 24 of the 26 HIV-positive patients were linked to HIV medical care. By July 2014, the monthly proportion of patients offered a test was 62%; the proportion of those offered a test who had a test ordered was 98%, and the proportion of those with a test ordered who were tested was 81%. Testing compliance increased substantially at the WHMC ED, from 77% in December 2013 to >98% in July 2014. Using compliance-monitoring, behavior-modification, and continuous quality-improvement processes produced substantial increases in offers and HIV test completion. WHMC is replicating this approach across departments, and other hospitals implementing routine HIV screening programs should consider this approach as well.

  13. Long-term Compliance with Oral 5-aminosalicylic Acid Therapy and Risk of Disease Recurrence in Patients with Ulcerative Colitis

    DEFF Research Database (Denmark)

    Prosberg, Michelle V; Vester-Andersen, Marianne K; Andersson, Mikael

    2016-01-01

    BACKGROUND: Noncompliance to long-term medical therapy is a well-known problem among patients treated for ulcerative colitis, but studies of long-term consequences in unselected patients are lacking. The authors aimed to determine the risk of recurrence according to long-term compliance with oral 5...

  14. Compliance als Schutz vor Verbandsverantwortlichkeit?

    Directory of Open Access Journals (Sweden)

    Alexander Tipold

    2016-05-01

    Full Text Available Compliance bedeutet nicht nur Einhaltung und Beachtung von Vorschriften, sondern betrifft auch Maßnahmen, die die Einhaltung der Rechtsnormen absichern sollen und läuft somit auf eine Übererfüllung von Verpflichtungen hinaus. Wenn es keinen klaren Maßstab für Kontroll- und Überwachungspflichten gibt, besteht die Gefahr, dass Strafverfolgungsbehörden die Compliance-Maßnahmen als Maßstab heranziehen und so eine Verschärfung der Pflichten erzeugen. Nach den Regeln des Verbandsverantwortlichkeitsgesetzes schließt im Übrigen das beste Compliance-System nicht zwingend die Verbandsverantwortlichkeit aus, steht aber unter Umständen einem Verfahren gegen den Verband entgegen.

  15. A Way to Understand Inpatients Based on the Electronic Medical Records in the Big Data Environment

    Directory of Open Access Journals (Sweden)

    Hongyi Mao

    2017-01-01

    Full Text Available In recent decades, information technology in healthcare, such as Electronic Medical Record (EMR system, is potential to improve service quality and cost efficiency of the hospital. The continuous use of EMR systems has generated a great amount of data. However, hospitals tend to use these data to report their operational efficiency rather than to understand their patients. Base on a dataset of inpatients’ medical records from a Chinese general public hospital, this study applies a configuration analysis from a managerial perspective and explains inpatients management in a different way. Four inpatient configurations (valued patients, managed patients, normal patients, and potential patients are identified by the measure of the length of stay and the total hospital cost. The implications of the finding are discussed.

  16. International Criminal Justice and the Politics of Compliance

    NARCIS (Netherlands)

    Lamont, Christopher

    2010-01-01

    International Criminal Justice and the Politics of Compliance provides a comprehensive study of compliance with legal obligations derived from the International Criminal Tribunal for the former Yugoslavia's (ICTY) Statute and integrates theoretical debates on compliance into international justice

  17. Modeling Patient Treatment With Medical Records: An Abstraction Hierarchy to Understand User Competencies and Needs.

    Science.gov (United States)

    St-Maurice, Justin D; Burns, Catherine M

    2017-07-28

    Health care is a complex sociotechnical system. Patient treatment is evolving and needs to incorporate the use of technology and new patient-centered treatment paradigms. Cognitive work analysis (CWA) is an effective framework for understanding complex systems, and work domain analysis (WDA) is useful for understanding complex ecologies. Although previous applications of CWA have described patient treatment, due to their scope of work patients were previously characterized as biomedical machines, rather than patient actors involved in their own care. An abstraction hierarchy that characterizes patients as beings with complex social values and priorities is needed. This can help better understand treatment in a modern approach to care. The purpose of this study was to perform a WDA to represent the treatment of patients with medical records. The methods to develop this model included the analysis of written texts and collaboration with subject matter experts. Our WDA represents the ecology through its functional purposes, abstract functions, generalized functions, physical functions, and physical forms. Compared with other work domain models, this model is able to articulate the nuanced balance between medical treatment, patient education, and limited health care resources. Concepts in the analysis were similar to the modeling choices of other WDAs but combined them in as a comprehensive, systematic, and contextual overview. The model is helpful to understand user competencies and needs. Future models could be developed to model the patient's domain and enable the exploration of the shared decision-making (SDM) paradigm. Our work domain model links treatment goals, decision-making constraints, and task workflows. This model can be used by system developers who would like to use ecological interface design (EID) to improve systems. Our hierarchy is the first in a future set that could explore new treatment paradigms. Future hierarchies could model the patient as a

  18. A systematic review of compliance with palivizumab administration for RSV immunoprophylaxis.

    Science.gov (United States)

    Frogel, Michael P; Stewart, Dan L; Hoopes, Michael; Fernandes, Ancilla W; Mahadevia, Parthiv J

    2010-01-01

    ;and an abstract database, Medical Intelligence Solution, for citations through April 2008. Specific search terms used were palivizumab with patient compliance, patient adherence, or patient persistence. Twenty-five articles and abstracts met the inclusion criteria. Available studies were mostly retrospective or observational prospective.Compliance, defined in various ways across the studies, varied between 25% and 100%, and 12 studies identified some of the factors related to noncompliance. Compliance generally was lower among Medicaid patients,African American patients, and other minorities. Ten studies (3 manuscripts and 7 abstracts) investigated the association of administration of prophylaxis through monthly home visits by a health professional with parental compliance with therapy. Most of the home-based programs were associated with higher compliance rates compared with clinic or office programs.Rates as high as 94% and 64% were achieved when Medicaid infants and infants of minority descent, respectively, received their doses through a home health program. When these infants received their doses at a clinic or office, depending on the definition of compliance, rates were 61%-100% for Medicaid infants and 44% for infants of minority descent. Reminder telephone calls to parents or caregivers, comprehensive multidisciplinary programs that included extensive counseling of parents, calendars with sticker reminders, and education in the language native to parents also were associated with increased compliance, although statistical significance was reported in only 1 study. Several studies recommended educating parents on the benefits of RSV prophylaxis, alleviating transportation and language difficulties, recognizing cultural differences and biases, and clarifying misperception of RSV illness severity. Home health programs had lower rates of RSV hospitalizations than office-based programs in 3 analyses conducted in 2 studies. In 4 other abstracts, the rates of RSV

  19. 77 FR 31371 - Public Workshop: Privacy Compliance Workshop

    Science.gov (United States)

    2012-05-25

    ... presentations, including the privacy compliance fundamentals, privacy and data security, and the privacy... DEPARTMENT OF HOMELAND SECURITY Office of the Secretary Public Workshop: Privacy Compliance... Homeland Security Privacy Office will host a public workshop, ``Privacy Compliance Workshop.'' DATES: The...

  20. Ratemaking and accounting for allowances and compliance costs

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    The regulatory treatment of compliance costs and allowances will significantly affect both the utility's CAAA compliance decisions and the cost of compliance. Sections in this chapter include ratemaking treatment of allowances, utility buy-ins, the market test of compliance costs and utility incentive, FERC account classification, measuring the value of allowances, inventory methods for allowances, expense recognition of allowances, regulatory-created assets and liabilities, and application of the FERC proposal. 8 refs., 1 tab

  1. Compliance with Use of Seat Belt among Commercial Drivers in a Nigerian Community

    Directory of Open Access Journals (Sweden)

    Oluwole C. Omolase

    2012-06-01

    Full Text Available AIM: This study aimed at determining compliance with use of seat belt among commercial intercity drivers. METHOD: This is a descriptive cross-sectional study conducted in Owo, South West Nigeria among commercial intercity drivers between June and September, 2009. Ethical clearance was obtained from the Ethical Review Committee of Federal Medical Centre, Owo, Ondo State, Nigeria prior to commencement of this study. The permission of the leadership of Road Transport Workers’ Union was also sought and obtained. Ninety intercity commercial drivers out of the estimated one hundred and sixty intercity commercial drivers in the community were enrolled in this study. Informed consent was obtained from each of the respondents. The data obtained was collated and analyzed with SPSS 15.0.1 statistical soft ware version. RESULTS: Ninety respondents were enrolled in this study. The driving experience of the respondents revealed that most respondents: 53 (58.9% had more than 20 years driving experience. Most respondents;78 (86.7% complied with use of seat belt .The main barrier to compliance with seat belt was short trip;28 (50.9%.Most respondents; 67 (74.4%were in support of penalization of defaulters. The major source of awareness about seat belt was Federal Road Safety Corps;59 (65.6%. CONCLUSION: Most respondents complied with use of seat belt. The major barrier to compliance with seat belt was short trip within the community. The Federal Road Safety Corps should enforce compliance with the use of seat belt most especially within communities. [TAF Prev Med Bull 2012; 11(3.000: 281-286

  2. Evaluating the Rate of Compliance with Radiation Protection Standards in Shohada Teaching Hospital -Tabriz

    Directory of Open Access Journals (Sweden)

    Faramarz Pourasghar

    2016-01-01

    Full Text Available ​ Background and Objectives : If proper diagnosis is regarded as the basis of modern medicine, medical radiography is the foundation of medical diagnosis. Properly applied radiography helps physicians to diagnose problems. On one side, using it to improve quality of life is essential but on the other hand, its hazards are obvious. A reasonable usage and according to protection standards are the best way to benefit its advantages and reduce the hazards. Material and Methods : This cross-sectional study was conducted by a researcher-made check list that its validity and reliability were confirmed by experts. It was performed as direct observation in Shohada teaching hospital. Collected data were entered into Excel software and analyzed applying descriptive statistics. Results : The results indicated that compliance with protection standards regarding staff protection ranged from 73.6 to 100 percent and it ranged from 0 to 99.2 percent regarding patient protection. Compliance with protection standards concerning the availability of the devices was lower than average but it was rated higher than average regarding environmental protection. Conclusion : In general, not all protection standards for radiological diagnostic tests are followed at the radiology ward in the shohada teaching hospital. Continuous training courses and increasing staff and patients' awareness might resolve this problem.

  3. Information security policy development for compliance

    CERN Document Server

    Williams, Barry L

    2013-01-01

    Although compliance standards can be helpful guides to writing comprehensive security policies, many of the standards state the same requirements in slightly different ways. Information Security Policy Development for Compliance: ISO/IEC 27001, NIST SP 800-53, HIPAA Standard, PCI DSS V2.0, and AUP V5.0 provides a simplified way to write policies that meet the major regulatory requirements, without having to manually look up each and every control. Explaining how to write policy statements that address multiple compliance standards and regulatory requirements, the book will he

  4. Utilization of handheld computing to simplify compliance

    International Nuclear Information System (INIS)

    Galvin, G.; Rasmussen, J.; Haines, A.

    2008-01-01

    Monitoring job site performance and building a continually improving organization is an ongoing challenge for operators of process and power generation facilities. Stakeholders need to accurately capture records of quality and safety compliance, job progress, and operational experiences (OPEX). This paper explores the use of technology-enabled processes as a means for simplifying compliance to quality, safety, administrative, maintenance and operations activities. The discussion will explore a number of emerging technologies and their application to simplifying task execution and process compliance. This paper will further discuss methodologies to further refine processes through trending improvements in compliance and continually optimizing and simplifying through the use of technology. (author)

  5. Compliance officers and legal advisers in power supply companies. interactions between compliance, risk management and the employer-employee relationship; Compliance-Beauftragte und Justitiare in EVU. Wechselwirkungen von Compliance, Risikomanagement und Arbeitsverhaeltnis

    Energy Technology Data Exchange (ETDEWEB)

    Gold, Juergen [Sozietaet Becker Buettner Held, Muenchen (Germany); Schaefer, Ralf; Bussmann, Sandra [Sozietaet Becker Buettner Held, Koeln (Germany)

    2011-06-15

    An inevitable task of any employee who has been appointed compliance officer, head of the legal department or internal auditor is to ensure that the company is protected against detriment through breaches of law or regulations. Another of his or her tasks, however, and one which might not be as obvious, is to ensure that parties outside the company are protected against detriment through his or her own employer. In order to deal appropriately with these and related questions some basic considerations on the necessity and function of compliance surveillance and its relationship with risk management must first be made. Using two significant court decisions for illustration the authors make a close examination of the liability issues involved in this area of potential conflict. They identify some salient points which should be considered in framing the contractual relationship between a compliance officer and his or her employer.

  6. Radiologic intervention: patient anxiety, fear of pain, understanding of the procedure and satisfaction with the medication-a prospective study

    International Nuclear Information System (INIS)

    Kim, Tae Hoon

    2006-01-01

    I wanted to prospectively assess patients' anxiety, their understanding of the procedure being performed, the perception of the pain level and the satisfaction with the administered medication for interventional procedures. I investigated 78 patients before and after they underwent 93 interventional procedures. The patients responded to a series of questions by using a visual analogue scale (VAS). Two different procedures were performed on 15 patients at different times. Based on the patient's body weight, a combination of sedative and analgesic was intravenously administered. The mean anxiety VAS score for the interventional procedures was about 5.3. The mean anxiety score of the experienced patients was about 3.8 and that of the inexperienced patients was about 5.5 (ρ < .001). The mean score for the understanding of the procedure, which was recorded both before and after the procedure, was about 4.1 and 7.1, respectively. The mean scores for the understanding of the procedure were about 7.0 in the experienced patients and about 3.6 in the inexperienced patients (ρ < .001). The anticipated level of pain recorded before the procedure was about 5.2 and the level of pain during the procedure was 2.9, and the latter was recorded after the procedure (ρ < .001). The level of satisfaction with the medication provided during the procedure was about 8.0 on the VAS score. The patients had a moderate amount of anxiety about the interventional procedures. Most patients had a high level of satisfaction with the medication despite the amount of pain they experienced during the procedure. The patients who were experienced with a procedure tended to have less anxiety and anticipated pain, and they had a greater understanding of the procedure

  7. Predicting compliance with an information-based residential outdoor water conservation program

    Science.gov (United States)

    Landon, Adam C.; Kyle, Gerard T.; Kaiser, Ronald A.

    2016-05-01

    Residential water conservation initiatives often involve some form of education or persuasion intended to change the attitudes and behaviors of residential consumers. However, the ability of these instruments to change attitudes toward conservation and their efficacy in affecting water use remains poorly understood. In this investigation the authors examine consumer attitudes toward complying with a persuasive water conservation program, the extent to which those attitudes predict compliance, and the influence of environmental contextual factors on outdoor water use. Results indicate that the persuasive program was successful in developing positive attitudes toward compliance, and that those attitudes predict water use. However, attitudinal variables explain a relatively small proportion of the variance in objectively measured water use behavior. Recommendations for policy are made stressing the importance of understanding both the effects of attitudes and environmental contextual factors in behavior change initiatives in the municipal water sector.

  8. Contemplating compliance: European compliance mechanisms in international perspective

    NARCIS (Netherlands)

    Koops, C.E.

    2014-01-01

    How can international organizations make their Member States comply with the rules of the organization? Which is the more effective method: to coax and entice, to argue and persuade, or to threaten and punish? On the basis of which criteria should a compliance mechanism be construed and applied,

  9. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Managing Cancer Care Finding Health Care Services Costs & Medical Information Advance Directives Using Trusted Resources Understanding Cancer ... Care Finding Health Care Services Managing Costs and Medical Information Advance Directives Using Trusted Resources Cancer Types ...

  10. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Research Managing Cancer Care Finding Health Care Services Costs & Medical Information Advance Directives Using Trusted Resources Understanding ... Managing Cancer Care Finding Health Care Services Managing Costs and Medical Information Advance Directives Using Trusted Resources ...

  11. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Care Finding Health Care Services Costs & Medical Information Advance Directives Using Trusted Resources Understanding Cancer What Is ... Health Care Services Managing Costs and Medical Information Advance Directives Using Trusted Resources Cancer Types Adolescents and ...

  12. Compliance with barrier precautions during paediatric trauma resuscitations.

    Science.gov (United States)

    Kelleher, Deirdre C; Carter, Elizabeth A; Waterhouse, Lauren J; Burd, Randall S

    2013-03-01

    Barrier precautions protect patients and providers from blood-borne pathogens. Although barrier precaution compliance has been shown to be low among adult trauma teams, it has not been evaluated during paediatric resuscitations in which perceived risk of disease transmission may be low. The purpose of this study was to identify factors associated with compliance with barrier precautions during paediatric trauma resuscitations. Video recordings of resuscitations performed on injured children (compliance with an established policy requiring gowns and gloves. Depending on activation level, trauma team members included up to six physicians, four nurses, and a respiratory therapist. Multivariate logistic regression was used to determine the effect of team role, resuscitation factors, and injury mechanism on barrier precaution compliance. Over twelve weeks, 1138 trauma team members participated in 128 resuscitations (4.7% penetrating injuries, 9.4% highest level activations). Compliance with barrier precautions was 81.3%, with higher compliance seen among roles primarily at the bedside compared to positions not primarily at the bedside (90.7% vs. 65.1%, pcompliance, while surgical attendings (20.8%) had the lowest (prole, increased compliance was observed during resuscitations of patients with penetrating injuries (OR=3.97 [95% CI: 1.35-11.70], p=0.01), during resuscitations triaged to the highest activation level (OR=2.61 [95% CI: 1.34-5.10], p=0.005), and among team members present before patient arrival (OR=4.14 [95% CI: 2.29-7.39], pCompliance with barrier precautions varies by trauma team role. Team members have higher compliance when treating children with penetrating and high acuity injuries and when arriving before the patient. Interventions integrating barrier precautions into the workflow of team members are needed to reduce this variability and improve compliance with universal precautions during paediatric trauma resuscitations. Copyright © 2012 Elsevier

  13. COMPLIANCE AS FACTORING BUSINESS RISK MANAGEMENT: CONTROL ASPECTS

    Directory of Open Access Journals (Sweden)

    V.K. Makarovych

    2016-03-01

    Full Text Available Indetermination of modern economy conditions and the lack of theoretical knowledge gained by domestic scientists about risk in factoring business actualize the research concerning the methodology and technique of factoring companies’ risk management. The article examines compliance which is the technology innovative for Ukrainian market of factoring risk management technologies. It is determined that the compliance is the risk management process directed to free will correspondence to state, international legislation as well as to the ethics standards accepted in the field of regulated legal relations and to the traditions of business circulation to sustain the necessary regulations and standards of market behaviour, and to consolidate the image of a factoring company. Compliance risks should be understood as the risks of missed profit or losses caused by the conflicts of interests and the discrepancy of employees’ actions to internal and external standard documents. The attention is paid to the control over the compliance. The author singles out 3 kinds of the compliance control such as institutional, operational and the compliance control over the observance of conducting business professional ethics regulations which are necessary for providing of efficient management of factoring business risks. The paper shows the organizing process of factoring business compliance control (by the development of internal standard documents, a compliance program, the foundation of compliance control subdivision, monitoring of the risks cause the choice, made by management entities of a factoring company, of the management methods of risks for their business. The development of new and improvement of existed forms of compliance control organizing process help satisfy users’ information needs and requests of the risk management factoring company department. The suggestions proposed create the grounds for the transformation and improvement of factoring

  14. Public understanding for medical radiation

    International Nuclear Information System (INIS)

    Yoo, Seongyeol

    1994-01-01

    Main sources of radiation exposure are radiography for the diagnosis of disease and radiation therapy to kill cancer cells, which are using X-ray generators or radioisotopes. The radiation of medical purpose irradiates intentionally to the patients. Another example of intentional exposure is occupational workers who are handling radiological equipment. The patients receive radiation more than the dose exposed to the occupational workers, but there is no doubt for the secondary radiation hazard. Although the epidemiologic studies represents that even low dose irradiation can cause epidemiologic studies represents that even low dose irradiation can cause cancer or congenital anomaly in human as a late effect, the risk is negligible, particularly when it is compared with the incidence of same disease in general population

  15. Business process compliance management : an integrated proactive approach

    NARCIS (Netherlands)

    Elgammal, A.; Sebahi, S.; Turetken, O.; Hacid, M.-S.; Papazoglou, M.; van den Heuvel, W.; Soliman, K.S.

    2014-01-01

    Today’s enterprises demand a high degree of compliance of business processes to meet regulations, such as Sarbanes-Oxley and Basel I-III. To ensure continuous guaranteed compliance, compliance management should be considered during all phases of the business process lifecycle; from the analysis and

  16. A paradigm for understanding trust and mistrust in medical research: The Community VOICES study.

    Science.gov (United States)

    Smirnoff, M; Wilets, I; Ragin, D F; Adams, R; Holohan, J; Rhodes, R; Winkel, G; Ricci, E M; Clesca, C; Richardson, L D

    2018-01-01

    To promote justice in research practice and rectify health disparities, greater diversity in research participation is needed. Lack of trust in medical research is one of the most significant obstacles to research participation. Multiple variables have been identified as factors associated with research participant trust/mistrust. A conceptual model that provides meaningful insight into the interplay of factors impacting trust may promote more ethical research practice and provide an enhanced, actionable understanding of participant mistrust. A structured survey was developed to capture attitudes toward research conducted in emergency situations; this article focuses on items designed to assess respondents' level of trust or mistrust in medical research in general. Community-based interviews were conducted in English or Spanish with 355 New York City residents (white 42%, African American 29%, Latino 22%). Generally favorable attitudes toward research were expressed by a majority (85.3%), but many respondents expressed mistrust. Factor analysis yielded four specific domains of trust/mistrust, each of which was associated with different demographic variables: general trustworthiness (older age, not disabled); perceptions of discrimination (African American, Latino, Spanish language preference); perceptions of deception (prior research experience, African American); and perceptions of exploitation (less education). The four domains identified in the analysis provide a framework for understanding specific areas of research trust/mistrust among disparate study populations. This model offers a conceptual basis for the design of tailored interventions that target specific groups to promote trust of individual researchers and research institutions as well as to facilitate broader research participation.

  17. Brief Report: Suggestibility, Compliance and Psychological Traits in High-Functioning Adults with Autism Spectrum Disorder

    Science.gov (United States)

    Maras, Katie L.; Bowler, Dermot M.

    2012-01-01

    Individuals with autism spectrum disorder (ASD) may be over-represented within the criminal justice system; it is therefore important to understand how they fare under police questioning. The present study examined interrogative suggestibility and compliance in individuals with ASD, and whether this is associated with certain psychological traits.…

  18. Achieving compliance with healthcare waste management regulations : empirical evidence from small European healthcare units

    OpenAIRE

    Botelho, Anabela

    2011-01-01

    Healthcare units generate substantial amounts of hazardous or potentially hazardous wastes as by-products of their medical services. The inappropriate management of these wastes poses significant risks to people and the environment. In Portugal, as in other EU countries, the collection, storage, treatment and disposal of healthcare waste is regulated by law. Although legal provisions covering the safe management of healthcare waste date back to the 1990s, little is known about the compliance ...

  19. 77 FR 41431 - Proposed Collection; Comment Request: Impact of Clinical Research Training and Medical Education...

    Science.gov (United States)

    2012-07-13

    ... Request: Impact of Clinical Research Training and Medical Education at the Clinical Center on Physician Careers in Academia and Clinical Research SUMMARY: In compliance with the requirement of Section 3506(c)(2... approval. Proposed Collection Title: The Impact of Clinical Research Training and Medical Education at the...

  20. Compliance with Antimalaria Chemoprophylaxis in a Combat Zone

    Science.gov (United States)

    Brisson, Michael; Brisson, Paul

    2012-01-01

    Compliance with malaria chemoprophylaxis by military service members (MSMs) is notoriously low, ranging from 30% to 56%. Our objective was to determine the rate of compliance and reasons for non-compliance with malaria chemoprophylaxis among healthy US MSMs in Afghanistan. An eight-question, anonymous online survey was used to collect data regarding the compliance of healthy MSMs with malaria chemoprophylaxis. E-mail surveys were sent to 1,200 MSMs; 528 (44%) MSMs completed the survey. One-time daily doxycycline was the most commonly prescribed chemoprophylaxis (90%); 60% (N = 318) responded that they were compliant with their chemoprophylaxis as prescribed, whereas 40% (N = 221) indicated that they were not compliant. Compliance with daily dosing was 61% and weekly dosing was 38%. The most common reasons for non-compliance were gastrointestinal effects (39%), forgetfulness (31%), and low perception of risk (24%). Malaria chemoprophylaxis compliance by healthy MSMs in Afghanistan is poor. Side effects, forgetfulness, and lack of education are contributing factors. Commanders bear the primary responsibility for the health of their soldiers, and the individual MSM bears personal responsibility; however, additional public health interventions could possibly have a positive impact on prevention. PMID:22492140

  1. INDONESIA SHARI'AH COMPLIANCE STOCK RETURN BEHAVIOUR

    Directory of Open Access Journals (Sweden)

    Helma Malini

    2017-04-01

    Full Text Available This study aims to measures the behaviour of Indonesia Shari'ah compliance stock return. The measurement of return behaviour toward volatility will proved the capability of Indonesia Shari'ah compliance toward volatility that happened in Indonesia during the period of observation. Investing in Shari'ah compliance is quite different than investing in conventional stock which followed the capital market set of rules and law, Shari'ah compliance follows not only the capital market set of laws and but also the Islamic principles of principles. Most of the previous studies examine issues related to the conventional stocks and market. The present study take one step further by investigating issue related to Shari'ah compliance instrument. In the case of Shari'ah stock price in Indonesia, the dynamics volatility of the stock price can be minimized by taking an integrated screening process to the listed company, as precautions steps toward volatility

  2. Self-assessment of treatment compliance with antimuscarinic drugs and lower urinary tract condition among women with urinary incontinence.

    Science.gov (United States)

    Kosilov, Kirill; Loparev, Sergey; Kuzina, Irina; Shakirova, Olga; Zhuravskaya, Natalya; Lobodenko, Alexandra

    2017-11-01

    Our aim was to determine the efficiency of the Medication Compliance Self-Report Inventory (MASRI) in self-reporting antimuscarinic drug treatment compliance among women with urinary incontinence (UI). The study assessed 347 women aged 18-65 (averaging 49.7) years with more than one urinary incontinence (UI) episode per day. Treatment compliance was tested at the beginning and at weeks 4, 8, and 12 using the MASRI, the Brief Medication Questionnaire (BMQ), and visual pill counts. The MASRI's constructive, concurrent, and discriminate validity was studied in comparison with an external standard that uses the chi-square and Spearman coefficient. Receiver operating characteristic (ROC) analysis was performed to identify optimum MASRI cutoffs that would predict noncompliance. Furthermore, the functional condition of the lower urinary tract was tested using voiding diaries, uroflowmetry, and cystometry. The correlation between the percentage of noncompliant women according to the MASRI, and individuals with a belief barrier with respect to the BMQ screen was r = 0.81 (p ≤0.05), r = 0.84 (p ≤0.05), and r = 0.79 (p ≤0.05). The correlation between the percentage of noncompliant women according to the MASRI and of women who missed >20% of their doses according to the Regimen Screen of the BMQ was r = 0.79, p ≤0.05, r = 0.82, p ≤0.01, r = 0.77, and p ≤0.05 at the control points. Finally, the percentage of noncompliant patients who self-reported correctly according to the MASRI data compared with the BMQ was 95.6%, 95.7%, and 96.6% at the control points. The MASRI entails acceptable validity for accurately predicting treatment compliance with antimuscarinic drugs among women who have had UI for >3 months.

  3. Long term telemedicine study of compliance in paranoid schizophrenia.

    Science.gov (United States)

    Krzystanek, Marek; Krzeszowski, Dariusz; Jagoda, Karolina; Krysta, Krzysztof

    2015-09-01

    Low compliance is one of the crucial problems of contemporary psychiatry. Relapses, deterioration of cognitive functioning, negative symptoms, neuroleptic resistance are the examples of many consequences of noncompliance in schizophrenia The study was designed to assess the compliance in the 200 patients diagnosed with paranoid schizophrenia, all in the state of symptomatic remission and on the stable neuroleptic treatment. The compliance was assessed using a telepsychiatric system, sending reminders: 1 hour before the planned dose to remind them that drug intake is approaching, and at the moment of intake to check if they took the drug. The confirmed drug intakes were counted by the telepsychiatric system. 158 patients completed the study period. The compliance in the first month of the treatment was 44.6% and decreased over the rest of the period to the level of 33.4%. 50% of the schizophrenic patients were compliant at a level lower than 37%. This group was considered the low compliance group, and in this group the compliance increased after 6 months from 9.3% to 10.3% (p<0.0001). The compliance in the group of schizophrenic patients in remission is very low. The telemedicine system improves the compliance in the patients with the worst compliance.

  4. Rocky Flats Compliance Program

    International Nuclear Information System (INIS)

    1994-02-01

    The Department of Energy (DOE) established the Office of Technology Development (EM-50) (OTD) as an element of Environmental Restoration and Waste Management (EM) in November 1989. The primary objective of the Office of Technology Development, Rocky Flats Compliance Program (RFCP), is to develop altemative treatment technologies for mixed low-level waste (wastes containing both hazardous and radioactive components) to use in bringing the Rocky Flats Plant (RFP) into compliance with Federal and state regulations and agreements. Approximately 48,000 cubic feet of untreated low-level mixed waste, for which treatment has not been specified, are stored at the RFP. The cleanup of the Rocky Flats site is driven by agreements between DOE, the Environmental Protection Agency (EPA), and the Colorado Department of Health (CDH). Under these agreements, a Comprehensive Treatment and Management Plan (CTMP) was drafted to outline the mechanisms by which RFP will achieve compliance with the regulations and agreements. This document describes DOE's strategy to treat low-level mixed waste to meet Land Disposal Restrictions and sets specific milestones related to the regulatory aspects of technology development. These milestones detail schedules for the development of technologies to treat all of the mixed wastes at the RFP. Under the Federal Facilities Compliance Act (FFCA), the CTMP has been incorporated into Rocky Flats Plant Conceptual Site Treatment Plan (CSTP). The CSTP will become the Rocky Flats Plant site Treatment Plan in 1995 and will supersede the CTMP

  5. [Compliance of long-acting atypical antipsychotics: from an image problem to a question of indication].

    Science.gov (United States)

    Naudin, J; Dassa, D; Cermolacce, M

    2009-09-01

    This paper focuses on the questions asked to practitioners regarding compliance to new long-acting atypical antipsychotics (LAAA): how does the comprehensive approach of patients' and carers' attitudes facing treatment challenge it? A review of recent literature shows that LAAA, are still suffering from an "image problem". We aim to describe these negative beliefs and suggest that LAAA indications be reconsidered. Following a comprehensive approach, we interpreted our review on the basis of anthropological criteria. We focused on value-based health and disease models that organize the attitude of patients and carers regarding the depot injection. Multiple negative beliefs attached to the pain, side-effects, and stigmas are well-known to impair adhesion to treatment. Carers understand disease as a lack of insight. Patients experience it as a threat for the Self and a loss of autonomy. The nurse-patient relationship involving injections is an important factor of compliance. When time is devoted by the carer to paying attention to the patient's experience, in order to perceive the patient as a participant, patients are more likely to adopt the injectable route themselves. By doing so, the patient considers the injection as a "protective net" a "lesser evil" by integrating it within his(her) biography. A comprehensive approach links the lack of insight to the patient's perception of stigma. Hope for recovery is related by the person him(her)self to his(her) own ability for autonomy. Persons with schizophrenia usually struggle for norms (agonomia). This trend has to be taken into account. LAAA are better indicated when patients are compliant. There is no indication when patients are "pure agonomics" and fight to deny both stigma and medication.

  6. 14 CFR 431.83 - Compliance monitoring.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Compliance monitoring. 431.83 Section 431.83 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... Requirements-Reusable Launch Vehicle Mission License Terms and Conditions § 431.83 Compliance monitoring. A...

  7. 14 CFR 437.93 - Compliance monitoring.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Compliance monitoring. 437.93 Section 437.93 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT....93 Compliance monitoring. A permittee must allow access by, and cooperate with, federal officers or...

  8. 14 CFR 420.49 - Compliance monitoring.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Compliance monitoring. 420.49 Section 420.49 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... Compliance monitoring. A licensee shall allow access by and cooperate with federal officers or employees or...

  9. 40 CFR 425.05 - Compliance dates.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Compliance dates. 425.05 Section 425.05 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS LEATHER TANNING AND FINISHING POINT SOURCE CATEGORY General Provisions § 425.05 Compliance dates...

  10. Diagnostic information in temporal compliance checking

    NARCIS (Netherlands)

    Ramezani Taghiabadi, E.; Fahland, D.; Dongen, van B.F.; Aalst, van der W.M.P.

    2012-01-01

    Compliance checking is gaining importance as today’s organizations need to show that operational processes are executed in a controlled manner while satisfying prede¿ned (legal) requirements. Deviations may be costly and expose the organization to severe risks. Compliance checking is of growing

  11. 34 CFR 1200.170 - Compliance procedures.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Compliance procedures. 1200.170 Section 1200.170 Education Regulations of the Offices of the Department of Education (Continued) NATIONAL COUNCIL ON... agency shall notify the Architectural and Transportation Barriers Compliance Board upon receipt of any...

  12. The Role of Compliance and Reaction Rate in Dehydration Weakening and Frictional Stability of Antigorite

    Science.gov (United States)

    Burdette, E.; Okazaki, K.; Hirth, G.

    2017-12-01

    The complicated brittle-ductile rheology of antigorite at subduction zone pressures and temperatures, resulting from its anisotropic mechanical properties, low dehydration temperature, and high water content has made interpretation of dehydration weakening problematic. Recent analyses indicate that antigorite is both ductile and brittle at high temperatures, and follows effective pressure frictional laws while dehydrating. In this study we focus on the role of rig compliance and reaction kinetics on frictional weakening and frictional stability. In addition, we correlate the evolution of mechanical behavior with AE activity at conditions within and above the thermal stability limit of antigorite. We conducted experiments at confining pressures from 0.25 GPa to 1GPa in a Griggs apparatus and modified rig compliance by including compliant components within the loading frame. We also modeled in-situ reaction progress using parameters from Sawai et al. (2013) to quantify relationships between weakening and fluid production. Without modifying the compliance, low pressure runs show stable dehydration weakening. With a modified, low compliance, results were nearly identical to stable weakening at standard compliance at 1 GPa. However, at lower pressures, many acoustic emissions were recorded at peak reaction rates during temperature ramping, with a rapid failure event occurring several minutes afterward (with the caveat that we still need to verify that AEs occur within the sample). No AEs are observed during room temperature experiments in samples that fault, nor were any observed in the high temperature experiments at conditions within the antigorite stability field - consistent with prior studies. Our results demonstrate that understanding in-situ dehydration reaction kinetics and their feedback with rheology and system compliance are key to scaling laboratory antigorite rheology to earth.

  13. Wall compliance and violin cavity modes.

    Science.gov (United States)

    Bissinger, George

    2003-03-01

    Violin corpus wall compliance, which has a substantial effect on cavity mode frequencies, was added to Shaw's two-degree-of-freedom (2DOF) network model for A0 ("main air") and A1 (lowest length mode included in "main wood") cavity modes. The 2DOF model predicts a V(-0.25) volume dependence for A0 for rigid violin-shaped cavities, to which a semiempirical compliance correction term, V(-x(c)) (optimization parameter x(c)) consistent with cavity acoustical compliance and violin-based scaling was added. Optimizing x(c) over A0 and A1 frequencies measured for a Hutchins-Schelleng violin octet yielded x(c) approximately 0.08. This markedly improved A0 and A1 frequency predictions to within approximately +/- 10% of experiment over a range of about 4.5:1 in length, 10:1 in f-hole area, 3:1 in top plate thickness, and 128:1 in volume. Compliance is a plausible explanation for A1 falling close to the "main wood" resonance, not increasingly higher for the larger instruments, which were scaled successively shorter compared to the violin for ergonomic and practical reasons. Similarly incorporating compliance for A2 and A4 (lowest lower-/upper-bout modes, respectively) improves frequency predictions within +/-20% over the octet.

  14. Variable effectiveness of stepwise implementation of nudge-type interventions to improve provider compliance with intraoperative low tidal volume ventilation.

    Science.gov (United States)

    O'Reilly-Shah, Vikas N; Easton, George S; Jabaley, Craig S; Lynde, Grant C

    2018-05-18

    Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system. Dashboards were emailed to providers four times over the course of the 9-month study. Additionally, the default setting on anaesthesia machines for tidal volume was decreased from 700 mL to 400 mL. Data on surgical cases performed between 1 September 2016 and 31 May 2017 were examined for compliance with LPV. The impact of the interventions was assessed via pairwise logistic regression analysis corrected for multiple comparisons. A total of 14 793 anaesthesia records were analysed. Absolute compliance rates increased from 59.3% to 87.8%preintervention to postintervention. Introduction of attending physician dashboards resulted in a 41% increase in the odds of compliance (OR 1.41, 95% CI 1.17 to 1.69, p=0.002). Subsequently, the addition of advanced practice provider and resident dashboards lead to an additional 93% increase in the odds of compliance (OR 1.93, 95% CI 1.52 to 2.46, p<0.001). Lastly, modifying ventilator defaults led to a 376% increase in the odds of compliance (OR 3.76, 95% CI 3.1 to 4.57, p<0.001). Audit and feedback tools in conjunction with default changes improve provider compliance. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise

  15. Energy Code Compliance in a Detailed Commercial Building Sample: The Effects of Missing Data

    Energy Technology Data Exchange (ETDEWEB)

    Biyani, Rahul K.; Richman, Eric E.

    2003-09-30

    Most commercial buildings in the U.S. are required by State or local jurisdiction to meet energy standards. The enforcement of these standards is not well known and building practice without them on a national scale is also little understood. To provide an understanding of these issues, a database has been developed at PNNL that includes detailed energy related building characteristics of 162 commercial buildings from across the country. For this analysis, the COMcheck? compliance software (developed at PNNL) was used to assess compliance with energy codes among these buildings. Data from the database for each building provided the program input with percentage energy compliance to the ASHRAE/IESNA Standard 90.1-1999 energy as the output. During the data input process it was discovered that some essential data for showing compliance of the building envelope was missed and defaults had to be developed to provide complete compliance information. This need for defaults for some data inputs raised the question of what the effect on documenting compliance could be due to missing data. To help answer this question a data collection effort was completed to assess potential differences. Using the program Dodge View, as much of the missing envelope data as possible was collected from the building plans and the database input was again run through COMcheck?. The outputs of both compliance runs were compared to see if the missing data would have adversely affected the results. Both of these results provided a percentage compliance of each building in the envelope and lighting categories, showing by how large a percentage each building either met or fell short of the ASHRAE/IESNA Standard 90.1-1999 energy code. The results of the compliance runs showed that 57.7 % of the buildings met or exceeded envelope requirements with defaults and that 68 % met or exceeded envelope requirements with the actual data. Also, 53.6 % of the buildings met or surpassed the lighting requirements

  16. Tax compliance costs: a business administration perspective

    OpenAIRE

    Eichfelder, Sebastian; Schorn, Michael

    2009-01-01

    The paper analyses the relationship of tax compliance costs and business strategy. Due to instruments, like information technology, simplified cash accounting or outsourcing compliance activities to tax advisers, private businesses have a set of strategies to optimize their tax compliance cost burden. Under the assumption of rational choice a private business should choose a cost-optimal administration strategy. In spite of that we find empirical evidence for small German businesses using onl...

  17. Compliance With Infection Prevention Guidelines By Health Care ...

    African Journals Online (AJOL)

    revealed varied levels of compliance on different components of infection prevention. The highest level of compliance (100%) was with single use of needles and syringes while the lowest (35.1) was with decontamination of needles and syringes with 0.5% chlorine solution prior to disposal. Compliance with hand hygiene ...

  18. 30 CFR 773.11 - Review of compliance history.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Review of compliance history. 773.11 Section... REGULATORY PROGRAMS REQUIREMENTS FOR PERMITS AND PERMIT PROCESSING § 773.11 Review of compliance history. (a... histories of compliance with the Act or the applicable State regulatory program, and any other applicable...

  19. Compliance to two city convenience store ordinance requirements

    Science.gov (United States)

    Menéndez, Cammie K Chaumont; Amandus, Harlan E; Wu, Nan; Hendricks, Scott A

    2015-01-01

    Background Robbery-related homicides and assaults are the leading cause of death in retail businesses. Robbery reduction approaches focus on compliance to Crime Prevention Through Environmental Design (CPTED) guidelines. Purpose We evaluated the level of compliance to CPTED guidelines specified by convenience store safety ordinances effective in 2010 in Dallas and Houston, Texas, USA. Methods Convenience stores were defined as businesses less than 10 000 square feet that sell grocery items. Store managers were interviewed for store ordinance requirements from August to November 2011, in a random sample of 594 (289 in Dallas, 305 in Houston) convenience stores that were open before and after the effective dates of their city’s ordinance. Data were collected in 2011 and analysed in 2012–2014. Results Overall, 9% of stores were in full compliance, although 79% reported being registered with the police departments as compliant. Compliance was consistently significantly higher in Dallas than in Houston for many requirements and by store type. Compliance was lower among single owner-operator stores compared with corporate/franchise stores. Compliance to individual requirements was lowest for signage and visibility. Conclusions Full compliance to the required safety measures is consistent with industry ‘best practices’ and evidence-based workplace violence prevention research findings. In Houston and Dallas compliance was higher for some CPTED requirements but not the less costly approaches that are also the more straightforward to adopt. PMID:26337569

  20. Caregivers' compliance with referral advice

    DEFF Research Database (Denmark)

    Lal, Sham; Ndyomugenyi, Richard; Paintain, Lucy

    2018-01-01

    BACKGROUND: Several malaria endemic countries have implemented community health worker (CHW) programmes to increase access to populations underserved by health care. There is considerable evidence on CHW adherence to case management guidelines, however, there is limited evidence on the compliance...... in the control arm were trained to treat malaria with ACTs based on fever symptoms. Caregivers' referral forms were linked with CHW treatment forms to determine whether caregivers complied with the referral advice. Factors associated with compliance were examined with logistic regression. RESULTS: CHW saw 18......,497 child visits in the moderate-to-high transmission setting and referred 15.2% (2815/18,497) of all visits; in the low-transmission setting, 35.0% (1135/3223) of all visits were referred. Compliance to referral was low, in both settings

  1. 49 CFR 28.170 - Compliance procedures.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Compliance procedures. 28.170 Section 28.170 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28.170 Compliance...

  2. Mobile Source Emissions Regulatory Compliance Data Inventory

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Mobile Source Emissions Regulatory Compliance Data Inventory data asset contains measured summary compliance information on light-duty, heavy-duty, and non-road...

  3. 75 FR 70881 - Designation of a Chief Compliance Officer; Required Compliance Policies; and Annual Report of a...

    Science.gov (United States)

    2010-11-19

    ... example, partnerships and limited liability companies) that may have forms of governing bodies other than... function subject to regulation by the Commission; if a limited liability company or limited liability... chief compliance officers to administer compliance policies that include, but are not limited to, all...

  4. Federal Facilities Compliance Act, Draft Site Treatment Plan: Compliance Plan Volume. Part 2, Volume 2

    International Nuclear Information System (INIS)

    1994-01-01

    This document presents the details of the implementation of the Site Treatment Plan developed by Ames Laboratory in compliance with the Federal Facilities Compliance Act. Topics discussed in this document include: implementation of the plan; milestones; annual updates to the plan; inclusion of new waste streams; modifications of the plan; funding considerations; low-level mixed waste treatment plan and schedules; and TRU mixed waste streams

  5. Developing an electronic system to manage and track emergency medications.

    Science.gov (United States)

    Hamm, Mark W; Calabrese, Samuel V; Knoer, Scott J; Duty, Ashley M

    2018-03-01

    The development of a Web-based program to track and manage emergency medications with radio frequency identification (RFID) is described. At the Cleveland Clinic, medication kit restocking records and dispense locations were historically documented using a paper record-keeping system. The Cleveland Clinic investigated options to replace the paper-based tracking logs with a Web-based program that could track the real-time location and inventory of emergency medication kits. Vendor collaboration with a board of pharmacy (BOP) compliance inspector and pharmacy personnel resulted in the creation of a dual barcoding system using medication and pocket labels. The Web-based program was integrated with a Cleveland Clinic-developed asset tracking system using active RFID tags to give the real-time location of the medication kit. The Web-based program and the asset tracking system allowed identification of kits nearing expiration or containing recalled medications. Conversion from a paper-based system to a Web-based program began in October 2013. After 119 days, data were evaluated to assess the success of the conversion. Pharmacists spent an average of 27 minutes per day approving medication kits during the postimplementation period versus 102 minutes daily using the paper-based system, representing a 74% decrease in pharmacist time spent on this task. Prospective reports are generated monthly to allow the manager to assess the expected workload and adjust staffing for the next month. Implementation of a BOP-approved Web-based system for managing and tracking emergency medications with RFID integration decreased pharmacist review time, minimized compliance risk, and increased access to real-time data. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  6. Compliance with the workplace-smoking ban in the Netherlands.

    Science.gov (United States)

    Verdonk-Kleinjan, Wendy M I; Rijswijk, Pieter C P; de Vries, Hein; Knibbe, Ronald A

    2013-02-01

    In 2004 the Dutch government instituted a workplace-smoking ban. This study focuses on differences in compliance over time and between occupational sectors, and describes the background variables. Telephone interviews were conducted with company employees across industry, public and service sectors in 2004 (n=705), 2006 (n=2201) and 2008 (n=2034). The questions concerned smoking policy, aspects of awareness and motivation to implement this ban. Compliance rates increased between 2006 (83%) and 2008 (96%) after an initial stagnation in the rate of compliance between 2004 and 2006. The increase in compliance was accompanied by a less negative attitude and an increase in confidence in one's ability to comply (self-efficacy). Differences in compliance between sectors with the highest compliance (public sector) and the lowest compliance (industry) decreased from about 20% to nearly 4%. Simultaneously, in the industry there was a stronger increase for risk perception of enforcement, social influence and self-efficacy. The initial stagnation in increase of compliance might be due to the lack of a (new) coherent package of policy measures to discourage smoking. Over the entire period there was a stronger increase in compliance in the industry sector, probably due to the intensification of enforcement activities and additional policy like legislation, which might increase awareness and social support. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  7. Understanding older adults' medication decision making and behavior: A study on over-the-counter (OTC) anticholinergic medications.

    Science.gov (United States)

    Holden, Richard J; Srinivas, Preethi; Campbell, Noll L; Clark, Daniel O; Bodke, Kunal S; Hong, Youngbok; Boustani, Malaz A; Ferguson, Denisha; Callahan, Christopher M

    2018-03-06

    Older adults purchase and use over-the-counter (OTC) medications with potentially significant adverse effects. Some OTC medications, such as those with anticholinergic effects, are relatively contraindicated for use by older adults due to evidence of impaired cognition and other adverse effects. To inform the design of future OTC medication safety interventions for older adults, this study investigated consumers' decision making and behavior related to OTC medication purchasing and use, with a focus on OTC anticholinergic medications. The study had a cross-sectional design with multiple methods. A total of 84 adults participated in qualitative research interviews (n = 24), in-store shopper observations (n = 39), and laboratory-based simulated OTC shopping tasks (n = 21). Simulated shopping participants also rank-ordered eight factors on their importance for OTC decision making. Findings revealed that many participants had concerns about medication adverse effects, generally, but were not aware of age-related risk associated with the use of anticholinergic medications. Analyses produced a map of the workflow of OTC-related behavior and decision making as well as related barriers such as difficulty locating medications or comparing them to an alternative. Participants reported effectiveness, adverse effects or health risks, and price as most important to their OTC medication purchase and use decisions. A persona analysis identified two types of consumers: the habit follower, who frequently purchased OTC medications and considered them safe; and the deliberator, who was more likely to weigh their options and consider alternatives to OTC medications. A conceptual model of OTC medication purchase and use is presented. Drawing on study findings and behavioral theories, the model depicts dual processes for OTC medication decision making - habit-based and deliberation-based - as well as the antecedents and consequences of decision making. This model suggests

  8. Wireless Technologies, Ubiquitous Computing and Mobile Health: Application to Drug Abuse Treatment and Compliance with HIV Therapies.

    Science.gov (United States)

    Boyer, Edward W; Smelson, David; Fletcher, Richard; Ziedonis, Douglas; Picard, Rosalind W

    2010-06-01

    Beneficial advances in the treatment of substance abuse and compliance with medical therapies, including HAART, are possible with new mobile technologies related to personal physiological sensing and computational methods. When incorporated into mobile platforms that allow for ubiquitous computing, these technologies have great potential for extending the reach of behavioral interventions from clinical settings where they are learned into natural environments.

  9. Aspirin for Evidence-Based Preeclampsia Prevention trial: influence of compliance on beneficial effect of aspirin in prevention of preterm preeclampsia.

    Science.gov (United States)

    Wright, David; Poon, Liona C; Rolnik, Daniel L; Syngelaki, Argyro; Delgado, Juan Luis; Vojtassakova, Denisa; de Alvarado, Mercedes; Kapeti, Evgenia; Rehal, Anoop; Pazos, Andrea; Carbone, Ilma Floriana; Dutemeyer, Vivien; Plasencia, Walter; Papantoniou, Nikos; Nicolaides, Kypros H

    2017-12-01

    The Aspirin for Evidence-Based Preeclampsia Prevention trial was a multicenter study in women with singleton pregnancies. Screening was carried out at 11-13 weeks' gestation with an algorithm that combines maternal factors and biomarkers (mean arterial pressure, uterine artery pulsatility index, and maternal serum pregnancy-associated plasma protein A and placental growth factor). Those with an estimated risk for preterm preeclampsia of >1 in 100 were invited to participate in a double-blind trial of aspirin (150 mg/d) vs placebo from 11-14 until 36 weeks' gestation. Preterm preeclampsia with delivery at preeclampsia in the Aspirin for Evidence-Based Preeclampsia Prevention trial. This was a secondary analysis of data from the trial. The proportion of prescribed tablets taken was used as an overall measure of compliance. Logistic regression analysis was used to estimate the effect of aspirin on the incidence of preterm preeclampsia according to compliance of preeclampsia at screening and the participating center. The choice of cut-off of 90% was based on an exploratory analysis of the treatment effect. Logistic regression analysis was used to investigate predictors of compliance ≥90% among maternal characteristics and medical history. Preterm preeclampsia occurred in 5/555 (0.9%) participants in the aspirin group with compliance ≥90%, in 8/243 (3.3%) of participants in the aspirin group with compliance preeclampsia was 0.24 (95% confidence interval, 0.09-0.65) for compliance ≥90% and 0.59 (95% confidence interval, 0.23-1.53) for compliance preeclampsia and negatively associated with smoking, maternal age preeclampsia in a previous pregnancy. The beneficial effect of aspirin in the prevention of preterm preeclampsia appears to depend on compliance. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. 30 CFR 90.207 - Compliance sampling.

    Science.gov (United States)

    2010-07-01

    ... MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.207 Compliance sampling. (a) The operator shall take five valid respirable dust samples for... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Compliance sampling. 90.207 Section 90.207...

  11. 5 CFR 900.406 - Compliance information.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Compliance information. 900.406 Section... Compliance information. (a) Cooperation and assistance. OPM, to the fullest extent practicable, shall seek... at the times, and in the form and containing the information OPM may determine necessary to enable it...

  12. 49 CFR 27.121 - Compliance information.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Compliance information. 27.121 Section 27.121 Transportation Office of the Secretary of Transportation NONDISCRIMINATION ON THE BASIS OF DISABILITY IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Enforcement § 27.121 Compliance information. (a) Cooperation and assistance. The...

  13. Recommendations to Improve the Implementation Compliance of Surgical Safety Checklist in Surgery Rooms

    Directory of Open Access Journals (Sweden)

    Juliana Sandrawati

    2014-11-01

    Full Text Available Background: Surgical Safety Checklist has been adopted in surgery room as a tool to improve safe surgery. Its implementation during 2012 was low (33.9% so was the completeness of filling it (57.3%. Objective: To increase the implementation of Surgical Safety Checklist (SSC through analyzing the effect of policy, procedures, patient safety culture, and individual factors on compliance SSC implementation in the surgery room. Methods: Cross-sectional study with descriptive observational approach was done to find influencing factors of health care personnels’ compliance to fill SSC. Sample consisted of all surgery room nurses (45 nurses, 10 surgeons and 4 anesthesists. Data collection was made use of questionnaires, surgical medical records and SSC form. Results:The compliance to fill SSC in April 2013 was still low (55.9%. Written policy on patient safety was absent and awareness of respondents about the procedure was low. Respondents’ assessment showed that patient safety culture in surgery room was good, except management and stress recognition dimensions. Likewise, the respondents’ knowledge about SSC was low (61.0%. Conclusion: The study conclude that influencing factors of compliance implementation SSC is absence of the written policy in patient safety, lack of socialization of Standar Prosedur Operasional to health care personnels, lack of knowledge about SSC, lack awareness about the importance of SSC, shortage of surgery room nurses, and innappropriate perception about filling SSC as workload. Recomendation:The study will be making of written policy in patient safety and SSC, followed by socialization to health care personnels, training about SSC implementation, empowering and advocating surgery room nurses and use of reminders.

  14. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications ... Psychological Treatments Understanding Stress Cognitive Behavioral ...

  15. Defending public interests in private lands: compliance, costs and potential environmental consequences of the Brazilian Forest Code in Mato Grosso.

    Science.gov (United States)

    Stickler, Claudia M; Nepstad, Daniel C; Azevedo, Andrea A; McGrath, David G

    2013-06-05

    Land-use regulations are a critical component of forest governance and conservation strategies, but their effectiveness in shaping landholder behaviour is poorly understood. We conducted a spatial and temporal analysis of the Brazilian Forest Code (BFC) to understand the patterns of regulatory compliance over time and across changes in the policy, and the implications of these compliance patterns for the perceived costs to landholders and environmental performance of agricultural landscapes in the southern Amazon state of Mato Grosso. Landholdings tended to remain in compliance or not according to their status at the beginning of the study period. The perceived economic burden of BFC compliance on soya bean and beef producers (US$3-5.6 billion in net present value of the land) may in part explain the massive, successful campaign launched by the farm lobby to change the BFC. The ecological benefits of compliance (e.g. greater connectivity and carbon) with the BFC are diffuse and do not compete effectively with the economic benefits of non-compliance that are perceived by landholders. Volatile regulation of land-use decisions that affect billions in economic rent that could be captured is an inadequate forest governance instrument; effectiveness of such regulations may increase when implemented in tandem with positive incentives for forest conservation.

  16. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in ... Agents Antidepressant Medications Newer IBS Medications Probiotics and ... Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation ...

  17. 14 CFR 417.23 - Compliance monitoring.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Compliance monitoring. 417.23 Section 417... Compliance monitoring. (a) A launch operator must allow access by, and cooperate with, Federal officers or... launch operator must provide the FAA with a console for monitoring the progress of the countdown and...

  18. 45 CFR 80.6 - Compliance information.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Compliance information. 80.6 Section 80.6 Public... THE CIVIL RIGHTS ACT OF 1964 § 80.6 Compliance information. (a) Cooperation and assistance. The... reports at such times, and in such form and containing such information, as the responsible Department...

  19. Sensory and instrumental analysis for slipperiness and compliance of food during swallowing.

    Science.gov (United States)

    Seo, H-S; Hwang, I K; Han, T R; Kim, I S

    2007-11-01

    In spite of its importance, there have been few attempts to evaluate the sensory attributes of the food bolus during swallowing. In the current study, the slipperiness, the degree of slide for the food bolus through the mucosal surface of the oro-pharynx, and the compliance, how easily the shape of a food bolus can be transformed for automatic and comfortable swallowing, were derived among several sensory attributes related to the swallowing. Therefore, the study aims were twofold: (1) to develop the methods of sensory and instrumental analyses for determining the slipperiness and compliance of the food bolus during swallowing and (2) to examine the appropriateness of the newly designed devices by correlating the data between the sensory and instrumental analyses. Six commercial food products were evaluated by 10 trained panelists for each attribute. The devices for assessing each attribute were developed in consideration of the oro-pharyngeal movements. The sensory and instrumental analyses showed high correlation and regression coefficients as well as intensity differences of the 6 samples for each attribute. In conclusion, the slipperiness and the compliance were suitable for acquiring a better understanding of the sensory attributes of the food bolus during swallowing, and the newly developed devices showed a high potential for determining those attributes.

  20. Tuberculosis in Canada: Detection, Intervention and Compliance

    Directory of Open Access Journals (Sweden)

    Katya Richardson

    2014-11-01

    Full Text Available This paper provides an overview of the current state of TB in Canada by referencing information presented at the workshop, “Tuberculosis: Detection, Prevention, and Compliance.” The workshop took place on November 14 and 15, 2012 in Ottawa. The workshop was organized by the Centre for Disease Modeling and the Public Health Agency of Canada as a two-day knowledge translation event that was comprised of scientific and policy focused presentations designed to address four key objectives: (1 Evaluate the success of current tuberculosis (TB health policies and control strategies in Canada and for specific Canadian sub-populations; (2 Determine the impact of detection, intervention, compliance, and education strategies in terms of TB incidence and prevalence; (3 Develop targets for future interventions by identifying key characteristics of TB epidemics that impact the success of TB health policies and control strategies; (4 Leverage our existing ties with public health decision makers, aboriginal health organizations, and organizations serving the homeless to develop a research community that is based on close collaboration, and will foster national TB control efforts. The workshop elicited robust discussions between experts from a variety of academic disciplines and government officials. A summary of the information presented, comments shared, and questions posed, will provide a comprehensive understanding of the status of TB in Canada and future directions to be taken for improved control of the disease.

  1. Compliance to two city convenience store ordinance requirements.

    Science.gov (United States)

    Chaumont Menéndez, Cammie K; Amandus, Harlan E; Wu, Nan; Hendricks, Scott A

    2016-04-01

    Robbery-related homicides and assaults are the leading cause of death in retail businesses. Robbery reduction approaches focus on compliance to Crime Prevention Through Environmental Design (CPTED) guidelines. We evaluated the level of compliance to CPTED guidelines specified by convenience store safety ordinances effective in 2010 in Dallas and Houston, Texas, USA. Convenience stores were defined as businesses less than 10 000 square feet that sell grocery items. Store managers were interviewed for store ordinance requirements from August to November 2011, in a random sample of 594 (289 in Dallas, 305 in Houston) convenience stores that were open before and after the effective dates of their city's ordinance. Data were collected in 2011 and analysed in 2012-2014. Overall, 9% of stores were in full compliance, although 79% reported being registered with the police departments as compliant. Compliance was consistently significantly higher in Dallas than in Houston for many requirements and by store type. Compliance was lower among single owner-operator stores compared with corporate/franchise stores. Compliance to individual requirements was lowest for signage and visibility. Full compliance to the required safety measures is consistent with industry 'best practices' and evidence-based workplace violence prevention research findings. In Houston and Dallas compliance was higher for some CPTED requirements but not the less costly approaches that are also the more straightforward to adopt. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Physician 'defiance' towards hand hygiene compliance: Is there a theory-practice-ethics gap?

    Science.gov (United States)

    Mortell, Manfred; Balkhy, Hanan H; Tannous, Elias B; Jong, Mei Thiee

    2013-07-01

    The theory-practice gap has always existed [1,2]. This gap is often cited as a culmination of theory being idealistic and impractical, even if practical and beneficial, is often ignored. Most of the evidence relating to the non-integration of theory and practice assumes that environmental factors are responsible and will affect learning and practice outcomes, hence the gap. Therefore, the author believes that to 'bridge the gap' between theory and practice, an additional dimension is required: ethics. A moral duty and obligation ensuring theory and practice integrate. In order to effectively implement new practices, one must deem these practices as worthy and relevant to their role as healthcare providers (HCP). Hence, this introduces a new concept which the author refers to as the theory-practice-ethics gap. This theory-practice-ethics gap must be considered when reviewing some of the unacceptable outcomes in healthcare practice [3]. The literature suggests that there is a crisis of ethics where theory and practice integrate, and healthcare providers are failing to fulfill our duty as patient advocates. Physician hand hygiene practices and compliance at King Abdulaziz Cardiac Centre (KACC) are consistent with those of other physicians in the global healthcare arena. That is one of noncompliance to King Abdulaziz Medical City (KAMC) organizational expectations and the World Health Organization (WHO) requirements? An observational study was conducted on the compliance of cardiac surgeons, cardiologists and nurses in the authors' cardiac center from January 2010 to December 2011. The hand hygiene (HH) compliance elements that were evaluated pertained to the WHO's five moments of HH recommendations. The data was obtained through direct observation by KAMC infection prevention and control practitioners. Physician hand hygiene compliance at KACC was consistently less than 60%, with nurses regularly encouraging physicians to be diligent with hand hygiene practices in the

  3. Improving Metadata Compliance for Earth Science Data Records

    Science.gov (United States)

    Armstrong, E. M.; Chang, O.; Foster, D.

    2014-12-01

    One of the recurring challenges of creating earth science data records is to ensure a consistent level of metadata compliance at the granule level where important details of contents, provenance, producer, and data references are necessary to obtain a sufficient level of understanding. These details are important not just for individual data consumers but also for autonomous software systems. Two of the most popular metadata standards at the granule level are the Climate and Forecast (CF) Metadata Conventions and the Attribute Conventions for Dataset Discovery (ACDD). Many data producers have implemented one or both of these models including the Group for High Resolution Sea Surface Temperature (GHRSST) for their global SST products and the Ocean Biology Processing Group for NASA ocean color and SST products. While both the CF and ACDD models contain various level of metadata richness, the actual "required" attributes are quite small in number. Metadata at the granule level becomes much more useful when recommended or optional attributes are implemented that document spatial and temporal ranges, lineage and provenance, sources, keywords, and references etc. In this presentation we report on a new open source tool to check the compliance of netCDF and HDF5 granules to the CF and ACCD metadata models. The tool, written in Python, was originally implemented to support metadata compliance for netCDF records as part of the NOAA's Integrated Ocean Observing System. It outputs standardized scoring for metadata compliance for both CF and ACDD, produces an objective summary weight, and can be implemented for remote records via OPeNDAP calls. Originally a command-line tool, we have extended it to provide a user-friendly web interface. Reports on metadata testing are grouped in hierarchies that make it easier to track flaws and inconsistencies in the record. We have also extended it to support explicit metadata structures and semantic syntax for the GHRSST project that can be

  4. Understanding the factors associated with initiation and adherence of osteoporosis medication in Japan: An analysis of patient perceptions

    Directory of Open Access Journals (Sweden)

    Hajime Orimo

    2017-12-01

    Conclusions: Different factors were found to be associated with initiation and adherence of osteoporosis medication. Patient knowledge of their disease and the perception of barriers were found to be the most influential. Empowering patients with the knowledge to better understand their disease and decreasing the perception of barriers through education initiatives may be effective in improving patient outcomes.

  5. Compliance with building energy regulations for new-build dwellings

    International Nuclear Information System (INIS)

    Pan, Wei; Garmston, Helen

    2012-01-01

    Despite increasingly stringent building energy regulations worldwide, non-compliance exists in practice. This paper examines the profile of compliance with building energy regulations for new-build dwellings. In total 404 new-build dwellings completed in the UK from 2006 to 2009 were investigated. Only a third of these dwellings were evidenced as being compliant with Building Regulations Part L (England and Wales). Such low compliance casts a serious concern over the achievability of the UK Government's target for all new-build homes to be ‘zero carbon’ from 2016. Clearly evidenced was a lack of knowledge of Part L and its compliance requirements among the supply and building control sides of new-build dwellings. The results also indicate that the compliance profile was influenced by factors including Standard Assessment Procedure (UK Government's methodology for energy efficiency) calculation submissions, learning and experience of builders and building controls with Part L, use of Part L1A checklist, the introduction of energy performance certificate (EPC), build method, dwelling type, and project size. Better compliance was associated with flats over houses and timber frame over masonry. The use of EPC and Part L1A checklist should be encouraged. Key to addressing the lack of compliance with building energy regulations is training. -- Highlights: ► There exists a lack of compliance, worldwide, with building energy regulations. ► The implementation of England and Wales building energy regulations is problematic. ► Training, learning and experience of builders and building control are critical. ► Energy performance certificate and Part L 2006 checklist helped achieve compliance. ► Flats achieved better compliance over houses; and timber frame over masonry.

  6. Hands in medicine: understanding the impact of competency-based education on the formation of medical students' identities in the United States.

    Science.gov (United States)

    Gonsalves, Catherine; Zaidi, Zareen

    2016-01-01

    There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on 'doing the work of a physician' rather than identity formation and 'being a physician.' This study aims to understand how competency-based education impacts the development of a medical student's identity. Three ceramic models representing three core competencies 'medical knowledge,' 'patient care,' and 'professionalism' were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Students across all four years of medical school related to the 'professionalism' competency domain (50%). They reflected that 'being an empathetic physician' was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized 'professionalism' as a competency. Students perceive 'professionalism' as a competency that impacts their identity formation in the social role of 'being a doctor,' albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception.

  7. Going GLP: Conducting Toxicology Studies in Compliance with Good Laboratory Practices.

    Science.gov (United States)

    Carroll, Erica Eggers

    2016-01-01

    Good laboratory practice standards are US federal regulations enacted as part of the Federal Insecticide, Fungicide, and Rodenticide Act (40 CFR Part 160), the Toxic Substance Control Act (40 CFR Part 792), and the Good Laboratory Practice for Nonclinical Laboratory Studies (21 CFR Part 58) to support protection of public health in the areas of pesticides, chemicals, and drug investigations in response to allegations of inaccurate data acquisition. Essentially, good laboratory practices (GLPs) are a system of management controls for nonclinical research studies involving animals to ensure the uniformity, consistency, reliability, reproducibility, quality, and integrity of data collected as part of chemical (including pharmaceuticals) tests, from in vitro through acute to chronic toxicity tests. The GLPs were established in the United States in 1978 as a result of the Industrial Bio-Test Laboratory scandal which led to congressional hearings and actions to prevent fraudulent data reporting and collection. Although the establishment of infrastructure for GLPs compliance is labor-intensive and time-consuming, achievement and maintenance of GLP compliance ensures the accuracy of the data collected from each study, which is critical for defending results, advancing science, and protecting human and animal health. This article describes how and why those in the US Army Medical Department responsible for protecting the public health of US Army and other military personnel made the policy decision to have its toxicology laboratory achieve complete compliance with GLP standards, the first such among US Army laboratories. The challenges faced and how they were overcome are detailed.

  8. Compliance with resolution and reasoning of its violation

    Directory of Open Access Journals (Sweden)

    Ladislav Lovaš

    2016-01-01

    Full Text Available The aim of the presented research is to confirm if it is possible to consider selfhandicapping and self-licensing as reasoning strategies of resolution violation in the process of resisting temptation. We have tried to confirm the existence of significant relationship and the possibility of prediction of resistance in compliance with resolutions, self-handicapping and self-licensing. We understand resolution as goal intention initiated and set by individual for himself/herself. Then, resistance in compliance with resolutions refers to high level of self-control and willpower in pursuing and attaining specific kind of goals or intentions – resolutions. It is the resistance to situational influences causing impulsive behavior. Self-handicapping is the self-protective strategy known as using of situational circumstances for excusing poor achievement. The third discussed term is self- licensing occuring when past moral behavior makes people more likely to do potentially immoral things without worrying about feeling or appearing immoral. We have used the sample of 121 university students aged from 18 to 30 years (average age = 22,2 years, standard deviation = 2,2. To measure the variables we have used three questionnaires, the questionnaire of Resistance in compliance with resolutions (Lovaš, Čopková, 2012, translated version of Self-Handicapping Scale (Jones, Rhodewalt, 1982 and Self- Licensing questionnaire constructed for the purpose of this research. We have supposed negative relationship between resistance in complinace with resolutions and both kinds of reasoning strategies of resolution violation. The Pearson correlation analysis has shown that there are significant negative relationship between variables of resistance in compliance with resolutions and self-handicapping (-0,332 (significance level p<0,01. The less significant negative relationship is between resistance in compliance with resolutions and self-licensing (-0,129. The

  9. Report: ECHO Data Quality Audit – Phase I Results: The Integrated Compliance Information System Needs Security Controls to Protect Significant Non-Compliance Data

    Science.gov (United States)

    Report #09-P-0226, August 31, 2009. End users of the Permit Compliance System and Integrated Compliance Information System National Pollutant Discharge Elimination System can override the Significant Non-Compliance data field without more access controls.

  10. A framework for understanding international medical graduate challenges during transition into fellowship programs.

    Science.gov (United States)

    Sockalingam, Sanjeev; Khan, Attia; Tan, Adrienne; Hawa, Raed; Abbey, Susan; Jackson, Timothy; Zaretsky, Ari; Okrainec, Allan

    2014-01-01

    Previous studies have highlighted unique needs of international medical graduates (IMG) during their transition into medical training programs; however, limited data exist on IMG needs specific to fellowship training. We conducted the following mixed-method study to determine IMG fellow training needs during the transition into fellowship training programs in psychiatry and surgery. The authors conducted a mixed-methods study consisting of an online survey of IMG fellows and their supervisors in psychiatry or surgery fellowship training programs and individual interviews of IMG fellows. The survey assessed (a) fellows' and supervisors' perceptions on IMG challenges in clinical communication, health systems, and education domains and (b) past orientation initiatives. In the second phase of the study, IMG fellows were interviewed during the latter half of their fellowship training, and perceptions regarding orientation and adaptation to fellowship in Canada were assessed. Survey data were analyzed using descriptive and Mann-Whitney U statistics. Qualitative interviews were analyzed using grounded theory methodology. The survey response rate was 76% (35/46) and 69% (35/51) for IMG fellows and supervisors, respectively. Fellows reported the greatest difficulty with adapting to the hospital system, medical documentation, and balancing one's professional and personal life. Supervisors believed that fellows had the greatest difficulty with managing language and slang in Canada, the healthcare system, and an interprofessional team. In Phase 2, fellows generated themes of disorientation, disconnection, interprofessional team challenges, a need for IMG fellow resources, and a benefit from training in a multicultural setting. Our study results highlight the need for IMG specific orientation resources for fellows and supervisors. Maslow's Hierarchy of Needs may be a useful framework for understanding IMG training needs.

  11. 22 CFR 141.5 - Compliance information.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Compliance information. 141.5 Section 141.5... DEPARTMENT OF STATE-EFFECTUATION OF TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 § 141.5 Compliance information... such information, as a responsible Departmental official or his designee may determine to be necessary...

  12. 49 CFR 21.9 - Compliance information.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Compliance information. 21.9 Section 21.9 Transportation Office of the Secretary of Transportation NONDISCRIMINATION IN FEDERALLY-ASSISTED PROGRAMS OF THE DEPARTMENT OF TRANSPORTATION-EFFECTUATION OF TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 § 21.9 Compliance information. (a) Cooperation and...

  13. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation ...

  14. Relationship between Medication Use and Cardiovascular Disease Health Outcomes in the Jackson Heart Study

    Directory of Open Access Journals (Sweden)

    Monique S. White

    2011-06-01

    Full Text Available Even though some medications have the potential to slow the progress of atherosclerosis and development of CVD, there are many at-risk individuals who continue to resist the benefits that are available by not following the advice of medical professionals. Non-adherence to prescribed drug regimens is a pervasive medical problem that negatively affects treatment outcomes. Information from standardized interviews of 5301 African Americans participating in the Jackson Heart Study was examined to determine the association between demographic parameters, behavior including adherence to prescribed medical regimens, and health outcomes. Data were also collected at Annual Follow-Up and Surveillance visits. During the two weeks prior to the examination visit, almost 52% of the participants reported taking blood pressure medication, 14% took cholesterol medication, 16% took medication for diabetes, and 19% took blood thinning medication. Of those who did not take the prescribed medications, the reasons given were the following: 47% were in a hurry, too busy, or forgot to take medications; 23% were trying to do without medications; 18% had no money to purchase medications; 19% indicated that the medications made them feel bad; 17% felt that they could not carry out daily functions when taking medications. The African American population can benefit from heightened awareness of the risk factors that are associated with CVD and the benefits of following a prescribed treatment regimen. Unacceptable secondary effects of prescribed medication comprised an important cause of non-compliance. Encouragement of this population to communicate with their healthcare providers to ensure that medication regimens are better tolerated could increase compliance and improve health outcomes.

  15. Influence of Self-Efficacy on Compliance to Workplace Exercise

    DEFF Research Database (Denmark)

    Pedersen, Mette Merete; Zebis, Mette K; Jørgensen, Henning Langberg

    2013-01-01

    the influence of exercise-specific self-efficacy on compliance to workplace physical exercise. PURPOSE: To determine the influence of exercise-specific self-efficacy on compliance to specific strength exercises during working hours for laboratory technicians. METHODS: We performed a cluster...... of compliance to exercises during 20 weeks, but found self-efficacy to be a predictor of compliance in a private sector setting. Workplace-specific differences might be present and should be taken into account....

  16. Indirect effect of management support on users' compliance behaviour towards information security policies.

    Science.gov (United States)

    Humaidi, Norshima; Balakrishnan, Vimala

    2018-01-01

    Health information systems are innovative products designed to improve the delivery of effective healthcare, but they are also vulnerable to breaches of information security, including unauthorised access, use, disclosure, disruption, modification or destruction, and duplication of passwords. Greater openness and multi-connectedness between heterogeneous stakeholders within health networks increase the security risk. The focus of this research was on the indirect effects of management support (MS) on user compliance behaviour (UCB) towards information security policies (ISPs) among health professionals in selected Malaysian public hospitals. The aim was to identify significant factors and provide a clearer understanding of the nature of compliance behaviour in the health sector environment. Using a survey design and stratified random sampling method, self-administered questionnaires were distributed to 454 healthcare professionals in three hospitals. Drawing on theories of planned behaviour, perceived behavioural control (self-efficacy (SE) and MS components) and the trust factor, an information system security policies compliance model was developed to test three related constructs (MS, SE and perceived trust (PT)) and their relationship to UCB towards ISPs. Results showed a 52.8% variation in UCB through significant factors. Partial least squares structural equation modelling demonstrated that all factors were significant and that MS had an indirect effect on UCB through both PT and SE among respondents to this study. The research model based on the theory of planned behaviour in combination with other human and organisational factors has made a useful contribution towards explaining compliance behaviour in relation to organisational ISPs, with trust being the most significant factor. In adopting a multidimensional approach to management-user interactions via multidisciplinary concepts and theories to evaluate the association between the integrated management

  17. On the quality of compliance mechanisms in the Kyoto Protocol

    International Nuclear Information System (INIS)

    Nentjes, Andries; Klaassen, Ger

    2004-01-01

    In this paper we evaluate the compliance mechanisms in the Kyoto Protocol as agreed at the seventh Conference of Parties to the United Nations Framework Convention on Climate Change (UNFCCC) in Marrakech. We differ from the literature since we concentrate on the complete set of compliance rules agreed in Marrakech and, as a new element, we systematically discuss these compliance incentives in conjunction with the implicit compliance incentives: reputation protection, emission trading and banking. We conclude that effectiveness and efficiency go hand in hand for all explicit and implicit compliance incentives except one--emission trading. Trading improves efficiency but this can also occur at the cost of increasing non-compliance

  18. Patients' and physicians' understanding of health and biomedical concepts: relationship to the design of EMR systems.

    Science.gov (United States)

    Patel, Vimla L; Arocha, José F; Kushniruk, André W

    2002-02-01

    The aim of this paper is to examine knowledge organization and reasoning strategies involved in physician-patient communication and to consider how these are affected by the use of computer tools, in particular, electronic medical record (EMR) systems. In the first part of the paper, we summarize results from a study in which patients were interviewed before their interactions with physicians and where physician-patient interactions were recorded and analyzed to evaluate patients' and physicians' understanding of the patient problem. We give a detailed presentation of one of such interaction, with characterizations of physician and patient models. In a second set of studies, the contents of both paper and EMRs were compared and in addition, physician-patient interactions (involving the use of EMR technology) were video recorded and analyzed to assess physicians' information gathering and knowledge organization for medical decision-making. Physicians explained the patient problems in terms of causal pathophysiological knowledge underlying the disease (disease model), whereas patients explained them in terms of narrative structures of illness (illness model). The data-driven nature of the traditional physician-patient interaction allows physicians to capture the temporal flow of events and to document key aspects of the patients' narratives. Use of electronic medical records was found to influence the way patient data were gathered, resulting in information loss and disruption of temporal sequence of events in assessing patient problem. The physician-patient interview allows physicians to capture crucial aspects of the patient's illness model, which are necessary for understanding the problem from the patients' perspective. Use of computer-based patient record technology may lead to a loss of this relevant information. As a consequence, designers of such systems should take into account information relevant to the patient comprehension of medical problems, which will

  19. ADHERENCE TO LONG-TERM TREATMENT OF CARDIOVASCULAR DISEASE AND NON-COMPLIANCE WITH MEDICAL RECOMMENDATIONS: THE OPINION OF PATIENTS AND PHYSICIANS BY THE RESULTS OF FOCUSED INTERVIEW

    Directory of Open Access Journals (Sweden)

    O. N. Semenova

    2015-09-01

    Full Text Available Aim. To study the subjective opinion of patients and doctors about their individual experiences with adherence to treatment for chronic cardiovascular diseases in the group focused interview of patients and their physicians.Material and methods. 3 groups of patients from clinical studies adhering to the doctor's recommendations (focus-group 1 and 3 groups of patients hospitalized for cardiovascular events, not adhering to recommendations after discharge (focus-group 2 and one focus-group of doctors were analyzed. Group discussion was performed by a moderator (experienced sociologist, with no medical training who was not familiar with the patients and physicians.Results. 47 patients (25 (53.2 % men and 22 (46.8% women and 6 doctors participated in the study. Paternalistic model of communication with doctors present in the minds of all patients. In patients of the first group this results in a full confidence in the doctor and compliance with all recommendations while in patients of the second group lack of care in the outpatient clinic makes them "offended" by the underestimation of their trust and causes non-compliance. Physicians intuitively divide patients into less and more "attractive" for themselves. This "division" on the one hand may have some predictive value in respect of patients’ adherence to a further treatment, and on the other hand, the "doctors’ prejudice" in relation to the patient may adversely effect the behavior of the patients and failure to follow the recommendations in the future.Conclusion. The significant paternalism on the part of the patient on the one hand increases the responsibility of the physician for his patient, and on the other hand – increases opportunities for his influence on the patients’ behavior.

  20. ADHERENCE TO LONG-TERM TREATMENT OF CARDIOVASCULAR DISEASE AND NON-COMPLIANCE WITH MEDICAL RECOMMENDATIONS: THE OPINION OF PATIENTS AND PHYSICIANS BY THE RESULTS OF FOCUSED INTERVIEW

    Directory of Open Access Journals (Sweden)

    O. N. Semenova

    2014-01-01

    Full Text Available Aim. To study the subjective opinion of patients and doctors about their individual experiences with adherence to treatment for chronic cardiovascular diseases in the group focused interview of patients and their physicians.Material and methods. 3 groups of patients from clinical studies adhering to the doctor's recommendations (focus-group 1 and 3 groups of patients hospitalized for cardiovascular events, not adhering to recommendations after discharge (focus-group 2 and one focus-group of doctors were analyzed. Group discussion was performed by a moderator (experienced sociologist, with no medical training who was not familiar with the patients and physicians.Results. 47 patients (25 (53.2 % men and 22 (46.8% women and 6 doctors participated in the study. Paternalistic model of communication with doctors present in the minds of all patients. In patients of the first group this results in a full confidence in the doctor and compliance with all recommendations while in patients of the second group lack of care in the outpatient clinic makes them "offended" by the underestimation of their trust and causes non-compliance. Physicians intuitively divide patients into less and more "attractive" for themselves. This "division" on the one hand may have some predictive value in respect of patients’ adherence to a further treatment, and on the other hand, the "doctors’ prejudice" in relation to the patient may adversely effect the behavior of the patients and failure to follow the recommendations in the future.Conclusion. The significant paternalism on the part of the patient on the one hand increases the responsibility of the physician for his patient, and on the other hand – increases opportunities for his influence on the patients’ behavior.