[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.

[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.

16 CFR 1115.8 - Compliance with product safety standards.

Science.gov (United States)

2010-01-01

... applicable mandatory consumer product safety standards and to report to the Commission any products which do.... 1115.8 Section 1115.8 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SUBSTANTIAL PRODUCT HAZARD REPORTS General Interpretation § 1115.8 Compliance with...

78 FR 21929 - Transmission Relay Loadability Reliability Standard; Notice of Compliance Filing

Science.gov (United States)

2013-04-12

... Relay Loadability Reliability Standard; Notice of Compliance Filing Take notice that on February 19... Relay Loadability Reliability Standard, Order No. 733, 130 FERC ] 61,221 (2010) (Order No. 733); order..., 136 FERC ] 61,185 (2011). \\2\\ Transmission Relay Loadability Reliability Standard, 138 FERC ] 61,197...

78 FR 55249 - Transmission Relay Loadability Reliability Standard; Notice of Compliance Filing

Science.gov (United States)

2013-09-10

...; RM11-16-000] Transmission Relay Loadability Reliability Standard; Notice of Compliance Filing Take.... \\1\\ Transmission Relay Loadability Reliability Standard, Order No. 733, 130 FERC ] 61, 221 (2010..., Order No. 733-B, 136 FERC ] 61,185 (2011). \\2\\ Transmission Relay Loadability Reliability Standard, 138...

Use of antibiotics and compliance with standard practices in Poultry ...

African Journals Online (AJOL)

Use of antibiotics and compliance with standard practices in Poultry Health ... African Journal of Sustainable Development ... Antibiotics use among poultry farmers was motivated by factors such as growth promotion ( x̄ = 2.38), ...

40 CFR 63.1108 - Compliance with standards and operation and maintenance requirements.

Science.gov (United States)

2010-07-01

..., air pollution control technologies, recovery technologies, work practices, pollution prevention... Source Categories: Generic Maximum Achievable Control Technology Standards § 63.1108 Compliance with... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR...

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

Compliance with the AM+L4776L/CFT International Standard; Lessons from a Cross-Country Analysis

OpenAIRE

Concha Verdugo Yepes

2011-01-01

This paper assesses countries' compliance with the Anti-Money Laundering and Combating the Financing of Terrorism (AML/CFT) international standard during the period 2004 to 2011. We find that overall compliance is low; there is an adverse impact on financial transparency created by the cumulative effects of poor implementation of standards on customer identification; and the current measurements of compliance do not take into account an analysis of ML/FT risk, thereby undermining their credib...

28 CFR 55.2 - Purpose; standards for measuring compliance.

Science.gov (United States)

2010-07-01

... the satisfaction of the Attorney General or to the U.S. District Court for the District of Columbia...; standards for measuring compliance. (a) The purpose of this part is to set forth the Attorney General's... to conduct elections in the language of certain “language minority groups” in addition to English. (b...

40 CFR 125.61 - Existence of and compliance with applicable water quality standards.

Science.gov (United States)

2010-07-01

... applicable water quality standards. 125.61 Section 125.61 Protection of Environment ENVIRONMENTAL PROTECTION... Water Act § 125.61 Existence of and compliance with applicable water quality standards. (a) There must exist a water quality standard or standards applicable to the pollutant(s) for which a section 301(h...

45 CFR 164.534 - Compliance dates for initial implementation of the privacy standards.

Science.gov (United States)

2010-10-01

... privacy standards. 164.534 Section 164.534 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164.534 Compliance dates for initial implementation of the privacy standards. (a...

Difference in compliance with Standard Precautions by nursing staff in Brazil versus Hong Kong.

Science.gov (United States)

Pereira, Fernanda Maria Vieira; Lam, Simon Ching; Chan, Jackie Hoi Man; Malaguti-Toffano, Silmara Elaine; Gir, Elucir

2015-07-01

The Standard Precautions (SP) are measures to reduce the risk of transmission of bloodborne and other pathogens, and should be used by health professionals in the care of all patients regardless of their condition of infection. However, suboptimal compliance with SP has been consistently reported in the nursing literature. This study evaluated the differences of compliance with SP among nurses from Brazil and Hong Kong. This cross-sectional study was conducted in 2 countries-Hong Kong and Brazil-with nurses working in hospitals who responded to a self-administered questionnaire with demographic data and responses to a 20-item Compliance with Standard Precautions Scale. The compliance rate of 560 nurses was 69.4% for the Brazilian sample and 57.4% for the Hong Kong sample. The additional clinical experience of the Brazilian nurses versus those in Hong Kong may be related to differences in compliance with SP between nurses. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Tool for evaluation compliance standards and expectations in occupational risk prevention by collaborating companies

International Nuclear Information System (INIS)

Duran Perez, A.; Gomez Pardo, M. A.; Cao Tejero, R.; Millan Verdejo, J. A.; Blas Perez, P.

2013-01-01

Within the framework of a single security in ANAV, in our Action Plan on prevention, we consider it essential to include workers from ECCE working for and by ANAV in compliance with standards and expectations both in the accounts of the incidents. With this system is intended to standardize a set of observed deviations report and a tool for measuring the degree of compliance, allowing to monitor the evolution of each company and the effectiveness of prevention plan.

The proposed combustion standards and DOE thermal treatment systems

International Nuclear Information System (INIS)

McFee, J.; Hinman, M.B.; Eaton, D.; NcNeel, K.

1997-01-01

Under the provisions of the Clean Air Act (CAA) concerning emission of hazardous air pollutants (HAPs), the Environmental Protection Agency (EPA) published the proposed Revised Standards for Hazardous Waste Combustors on April 19, 1996 (EPA, 1996). These standards would apply to the existing Department of Energy (DOE) radioactive and mixed waste incinerators, and may be applied to several developing alternatives to incineration. The DOE has reviewed the basis for these regulations and prepared extensive comments to present concerns about the bases and implications of the standards. DOE is now discussing compliance options with the EPA for regulation of radioactive and mixed waste thermal treatment systems

40 CFR 1033.240 - Demonstrating compliance with exhaust emission standards.

Science.gov (United States)

2010-07-01

... (CONTINUED) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM LOCOMOTIVES Certifying Engine Families § 1033... engine family is considered in compliance with the applicable numerical emission standards in § 1033.101... certify by design without new emission test data. To do this, submit the application for certification...

40 CFR 65.3 - Compliance with standards and operation and maintenance requirements.

Science.gov (United States)

2010-07-01

...)(4)(i) and (ii) do not apply to Group 2A or Group 2B process vents. Compliance with design, equipment, work practice, and operational standards, including those for equipment leaks, shall be determined... this part. (5) Design, equipment, work practice, or operational standards. Paragraphs (b)(5)(i) and (ii...

California's Low-Carbon Fuel Standard - Compliance Trends

Science.gov (United States)

Witcover, J.; Yeh, S.

2013-12-01

Policies to incentivize lower carbon transport fuels have become more prevalent even as they spark heated debate over their cost and feasibility. California's approach - performance-based regulation called the Low Carbon Fuel Standard (LCFS) - has proved no exception. The LCFS aims to achieve 10% reductions in state transport fuel carbon intensity (CI) by 2020, by setting declining annual CI targets, and rewarding fuels for incremental improvements in CI beyond the targets while penalizing those that fail to meet requirements. Even as debate continues over when new, lower carbon fuels will become widely available at commercial scale, California's transport energy mix is shifting in gradual but noticeable ways under the LCFS. We analyze the changes using available data on LCFS fuels from the California Air Resources Board and other secondary sources, beginning in 2011 (the first compliance year). We examine trends in program compliance (evaluated through carbon credits and deficits generated), and relative importance of various transport energy pathways (fuel types and feedstocks, and their CI ratings, including new pathways added since the program's start). We document a roughly 2% decline in CI for gasoline and diesel substitutes under the program, with compliance achieved through small shifts toward greater reliance on fuels with lower CI ratings within a relatively stable amount of transport energy derived from alternatives to fossil fuel gasoline and diesel. We also discuss price trends in the nascent LCFS credit market. The results are important to the broader policy debate about transportation sector response to market-based policies aimed at reducing the sector's greenhouse gas emissions.

SRS ES and H Standards Compliance Program Implementation Plan

International Nuclear Information System (INIS)

Hearn, W.H.

1993-01-01

On March 8, 1990, the Defense Nuclear Facilities Safety Board (DNFSB) issued Recommendation 90-2 to the Secretary of Energy. This recommendation, based upon the DNFSB's initial review and evaluation of the content and implementation of standards relating to the design, construction, operations, and decommissioning of defense nuclear facilities of the U.S. Department of Energy (DOE), called for three actions: identification of specific standards that apply to design, construction, operation and decommissioning of DOE facilities; assessment of the adequacy of those standards for protecting public health and safety; and determination of the extent to which they have and are being implemented. The purpose of this Implementation Plan is to define the single program for all sitewide and facility 90-2 ES and H Standards Compliance efforts, which will satisfy the HQ Implementation Plan, avoid duplicate efforts, be as simple and achievable as possible, include cost-saving innovations, use a graded approach based on facility hazards and future needs of facilities, and support configuration control for facility requirements. The Defense Waste Processing Facility (DWPF) has been designated a pilot facility for the 90-2 program and has progressed with their facility program ahead of the site-level program. The DWPF, and other Government-Owned Contractor-Operated (GOCO) facilities that progress on an enhanced schedule, will serve as pilot facilities for the site-level program. The lessons learned with their requirement identifications, and their assessments of the adequacy of and their compliance with these requirements will be used to improve the efficiency of the site-level and subsequent programs

78 FR 44557 - Revision to Transmission Vegetation Management Reliability Standard; Notice of Compliance Filing

Science.gov (United States)

2013-07-24

... Transmission Vegetation Management Reliability Standard; Notice of Compliance Filing Take notice that on July 12, 2013, the North American Electric Reliability Corporation (NERC), pursuant to Order No. 777 \\1... Reliability Standard FAC-003-2 to its Web site. \\1\\ Revisions to Reliability Standard for Transmission...

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 ...

Predictors of compliance with community-directed treatment with ivermectin for onchocerciasis control in Kabo area, southwestern Ethiopia.

Science.gov (United States)

Endale, Adugna; Erko, Berhanu; Weldegebreal, Fitsum; Legesse, Mengistu

2015-02-15

Compliance with annual ivermectin treatment is a major challenge in community-directed treatment with ivermectin (CDTI) implementation. There are individuals who do not comply with the annual mass treatment, which contributes to the continuity for disease transmission. Hence, ensuring high treatment coverage and sustained compliance should be given due emphasis in the control of onchocerciasis. The aim of this study was to determine CDTI compliance rate and predictors of compliance where the CDTI was in its 9(th) round in Kabo area, southwestern Ethiopia. Community-based cross-sectional study was conducted in Kabo area, three weeks after the 9th round of annual ivermectin distribution. Systematic random sampling was used to select head of households and structured, pre-tested questionnaire was used to interview the study participants. Data was analyzed using SPSS version 16. Descriptive statistics was used to compute mean and standard deviation of continuous variables and frequency for categorical variables, while bivariate and multivariate logistic regressions were used to assess the effects of independent variables on the outcome variable. Variables which showed association in multivariate analysis were considered as final predictors of compliance and strength of association was measured through adjusted odds ratio (AOR). A total of 308 respondents (age range 18-70, mean age ± SD, 32.21 ± 9.64) participated in the study. Of these, 249 (80.8%) reported that they took ivermectin during the 9th round annual treatment. Significantly higher rate of treatment compliance was reported by participants age ≥35 years (AOR = 5.48, 95% CI; 1.97 - 15.23), participants who stayed in the area for more than ten years (AOR = 3.86, 95% CI; 1.83- 8.11), participants who perceive that they are at risk of contracting the disease(AOR = 7.05, 2.70- 18.43), participants who perceive community drug distributors (CDDs) are doing their work well (AOR = 2.35 95% CI; 1

Non-compliance with growth hormone treatment in children is common and impairs linear growth.

Directory of Open Access Journals (Sweden)

Wayne S Cutfield

Full Text Available BACKGROUND: GH therapy requires daily injections over many years and compliance can be difficult to sustain. As growth hormone (GH is expensive, non-compliance is likely to lead to suboptimal growth, at considerable cost. Thus, we aimed to assess the compliance rate of children and adolescents with GH treatment in New Zealand. METHODS: This was a national survey of GH compliance, in which all children receiving government-funded GH for a four-month interval were included. Compliance was defined as ≥ 85% adherence (no more than one missed dose a week on average to prescribed treatment. Compliance was determined based on two parameters: either the number of GH vials requested (GHreq by the family or the number of empty GH vials returned (GHret. Data are presented as mean ± SEM. FINDINGS: 177 patients were receiving GH in the study period, aged 12.1 ± 0.6 years. The rate of returned vials, but not number of vials requested, was positively associated with HVSDS (p < 0.05, such that patients with good compliance had significantly greater linear growth over the study period (p<0.05. GHret was therefore used for subsequent analyses. 66% of patients were non-compliant, and this outcome was not affected by sex, age or clinical diagnosis. However, Maori ethnicity was associated with a lower rate of compliance. INTERPRETATION: An objective assessment of compliance such as returned vials is much more reliable than compliance based on parental or patient based information. Non-compliance with GH treatment is common, and associated with reduced linear growth. Non-compliance should be considered in all patients with apparently suboptimal response to GH treatment.

The EEG response to the repromulgated standard and compliance process

International Nuclear Information System (INIS)

Neill, R.H.; Chaturvedi, L.; Lee, W.W.L.

1993-01-01

Since 1978, the New Mexico Environmental Evaluation Group (EEG) has provided an independent technical evaluation of the Waste Isolation Pilot Plant (WIPP) to ensure protection of the public health and safety of New Mexicans and protection of the environment in New Mexico. Through its technical competence and continuity, the EEG has had a major influence on the course of the WIPP. This paper summarizes our views on the 1993 repromulgation of the general environmental standards for high-level and transuranic waste disposal and the certification for compliance with the standard

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

Impact of cognitive function on compliance with treatment in heart failure

Directory of Open Access Journals (Sweden)

Beata Jankowska-Polańska

2017-02-01

Full Text Available In heart failure (HF patients frailty syndrome and cognitive impairment (CI affect outcome by decreasing the capability for performing self-care, adhering to the prescribed treatment regimen, monitoring symptoms. The aim was to investigate whether CI affects the compliance to therapeutic regimens. Methods: 170 with HF were included. We employed the Mini Mental State Examination (MMSE, for dementia and the Revised Heart Failure Compliance Scale to assess compliance. Results: CI patients showed lower compliance in all domains: 2.8±1.0 vs 3.3±1.0 (keeping appointments, 2.8±0.9 vs. 3.4±0.9 (pharmaceutical compliance, 0.4±0.8 vs. 1.4±1.2 (regular body weight monitoring, 2.0±1.3 vs. 2.7±1.0 (reduced salt intake, 1.9±1.2vs. 2.9±1.0 (fluid intake restriction, and 0.5±0.8 vs. 1.7±1.1 (regular exercise. Multiple regression analysis showed cognitive function to be an independent predictor for regular body weight monitoring (β=1.223;p<0.001, fluid intake restriction (β=1.081;p<0.001, and regular exercise (β=1.237;p<0.001. In multivariate analysis, the stimulant variables for compliance with HF treatment were: education (β=1.124, being in a relationship (β=2.231, and lack of cognitive impairment (β=0.320; the number of hospitalizations due to HF was identified as a destimulant (β=-0.495. Conclusion: Non-compliance is a major problem in elderly with HF. The cognitive function is an independent contributor to total compliance and to compliance with non-pharmaceutical recommendations. Being in a relationship and education are independent predictors of better compliance, while the number of rehospitalizations due to HF exacerbations is an independent predictor of worse compliance. Early detection of CI may offer an opportunity for intervention and a key strategy for improving clinical outcomes in older adults with HF.

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...

Retail electricity price savings from compliance flexibility in GHG standards for stationary sources

International Nuclear Information System (INIS)

Burtraw, Dallas; Woerman, Matt; Paul, Anthony

2012-01-01

The EPA will issue rules regulating greenhouse gas (GHG) emissions from existing steam boilers and refineries in 2012. A crucial issue affecting the scope and cost of emissions reductions will be the potential introduction of flexibility in compliance, including averaging across groups of facilities. This research investigates the role of compliance flexibility for the most important of these source categories—existing coal-fired power plants—that currently account for one-third of national emissions of carbon dioxide, the most important greenhouse gas. We find a flexible standard, calibrated to achieve the same emissions reductions as a traditional(inflexible) approach, reduces the increase in electricity price by 60 percent and overall costs by two-thirds in 2020. The flexible standard also leads to substantially more investment to improve the operating efficiency of existing facilities, whereas the traditional standard leads to substantially greater retirement of existing facilities. - Highlights: ► The U.S. EPA will regulate GHG emissions from power plants under the Clean Air Act. ► We compare a flexible standard with fleet-wide averaging to a traditional standard. ► Flexible standard reduces the increase in electricity price by 60percent in 2020. ► Flexible standard reduces the increase in overall costs by two-thirds in 2020. ► Flexible standard leads to more efficiency investment and less capacity retirement.

Does compliance with amblyopia management improve following supervised occlusion treatment?

Science.gov (United States)

El-Ghrably, I A; Longville, D; Gnanaraj, L

2007-01-01

To demonstrate improvement in compliance following supervised occlusion therapy for amblyopia in children who had failed to respond to outpatient treatment. Retrospective review of the visual outcome of 30 children who were admitted to an ophthalmology ward for 1-day intensive supervised occlusion. These children had documented poor compliance and previously failed to respond to the outpatient occlusion treatment. During their stay a trained ophthalmology nurse educated parents regarding amblyopia and the benefits of occlusion therapy. Visual acuity (VA) of the amblyopic and fellow eyes was recorded on admission, discharge, and at each subsequent visit. The compliance was recorded from parent's history and also indirectly by noticing improvement in vision. The mean supervised occlusion was 7.4 hours (range 4-12 hours). The compliance with occlusion therapy improved in 23 children (77%) after discharge. The mean duration of occlusion after discharge improved to 4 hours (range 1-12 hours). The mean follow-up was 18 months (range 4-24 months). Though there was no dramatic improvement in VA at discharge there was a statistically significant improvement in VA between admission and last recorded VA (pocclusion following discharge, 21 (91%) gained at least one line of acuity in their amblyopic eye on the last assessment of their VA and five of them achieved 6/12. Of the seven children who did not comply with occlusion following discharge, only one patient gained one line improvement in his amblyopic eye. This study shows that supervised occlusion treatment and parental education was effective in children who had initially failed traditional outpatient treatment.

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

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.

Radiation treatment compliance in the indigenous population: the pilot of Northern Territory experience and future directions

International Nuclear Information System (INIS)

Le, Hien; Carruthers, Scott; Penniment, Michael; Roos, Daniel; Sullivan, Thomas; Baxi, Siddhartha

2013-01-01

There is a perception that Indigenous patients are less likely to attend radiotherapy treatment. This study sought to determine if a difference in radiotherapy treatment compliance rates exists between Indigenous and non-Indigenous patients. Secondly, we aimed to ascertain which patient, disease and treatment factors affect compliance in Indigenous patients. All patients treated with radiotherapy at the Alan Walker Cancer Care Centre between March and October 2010 were analysed. Data regarding compliance rates (defined as those who chose and completed the recommended course of treatment), patient, disease and treatment factors were collected, and chi-squared and Fisher's exact tests were applied. A total of 41 courses were delivered to Indigenous patients and 224 courses delivered to non-Indigenous patients in this period. There was no difference in compliance between Indigenous and non-Indigenous patients (83% vs. 81%, P=0.75). Of the factors assessed, it was found that there was an association between toxicity grade and compliance (P=0.048). From this cohort, we cannot support the perception that Indigenous patients have overall poorer compliance with recommended radiation treatment courses. In this study, the only factor which correlated significantly with compliance was toxicity grade. It is felt that a number of factors, which negatively impact on compliance, can potentially be counteracted by a culturally sensitive model of care.

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.

Factors affecting compliance to treatment among children with ...

African Journals Online (AJOL)

BACKGROUND:This study aimed to determine the factors affecting compliance to treatment among children with epilepsy in Enugu,Nigeria. METHODS: Children with diagnosis of epilepsy were consecutively recruited.Their 6 months retrospective and 1 month prospective data were collected;and analyzed using SPSS ...

Psychological comorbidities and compliance to interventional treatment of patients with cutaneous vascular malformations.

Science.gov (United States)

Kenny, Stephanie A; Majeed, Nevin; Zhand, Naista; Glikstein, Rafael; Agid, Ronit; Dos Santos, Marlise P

2016-08-01

The aim of this study was to assess qualitatively the psychological stressors affecting patients with cutaneous vascular malformations and hemangiomas (CVM-H) and their impact on compliance to interventional treatment. A retrospective chart review was conducted of all patients with CVM-H treated by interventional neuroradiology at a single academic institution during a five-year period (2009-2014). Psychological complaints were documented during each clinic visit by a neuroradiologist. Compliance to interventional treatment was defined by adherence to the scheduled treatment sessions. Fisher's exact test was used to assess for associations between psychological complaints and compliance. Seventy-five patients were assessed, of whom 49 (65.3%) were female, with an age range of 2-78 years (mean age 30.2 years). All except one patient older than seven years of age (n = 71; 94.6%) had a psychological complaint, including fear of negative appearance (n = 53; 70.6%), dissatisfaction with appearance (n = 46; 61.3%), low self-esteem (n = 35; 46.6%), anxiety (n = 16; 21.3%), stress (n = 13; 17.3%), bullying (n = 5; 6.6%), and low mood (n = 4; 5.3%). Twenty-three (31%) patients were non-compliant. Low self-esteem was significantly associated with non-compliance (p = 0.0381). There is a high prevalence of psychological comorbidities among patients treated for CVM-H. This has potential implications for interventional treatment, as it was found that low self-esteem is significantly associated with non-compliance. These results suggest the need for early psychological support in these patients in order to maximize compliance to interventional treatment. © The Author(s) 2016.

[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.

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.

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

A perspective on demonstrating compliance with standards for disposal of high-level radioactive wastes

International Nuclear Information System (INIS)

Kocher, D.C.; Smith, E.D.; O'Kelley, G.D.; Sjoreen, A.L.

1985-01-01

A perspective which the authors have developed on the problem of demonstrating that geologic repositories for the disposal of high-level radioactive wastes will comply with system performance standards is discussed. Their viewpoint arises from a concern that the U.S. Environmental Protection Agency's proposed environmental standard for high-level waste disposal appears to require demonstrations of compliance which are incompatible with scientific knowledge; i.e., the standard does not take into account the likely importance of unquantifiable and unresolvable uncertainty in repository performance-assessment models. A general approach to demonstrations of compliance is proposed which is thought to be compatible with the kinds of technical information that will be available for judging long-term repository performance. The authors' approach emphasizes the importance of investigating alternative conceptual models and lines of reasoning in evaluating repository performance and the importance of subjective scientific judgment in the decision-making process. (Auth.)

Cyber security. Compliance to the new CSA 290.7 standard

Energy Technology Data Exchange (ETDEWEB)

Daley, M.; Doucet, R.; Echlin, M.; MacDonald, M.; Mihaylov, V.; Sijs, J.; Trask, D. [Canadian Nuclear Laboratories, Chalk River, Ontario (Canada)

2015-12-15

Since 2008, the Canadian Nuclear Safety Commission (CNSC), similar to regulators of other critical industries, has requested their licensees to implement cyber security programs and conduct self- assessments without the benefit of an industry specific cyber security standard that provides common metrics for coverage and effectiveness of their programs. However, for the nuclear industry, a new CSA standard 290.7 entitled 'Cyber security for nuclear power plants and small reactor facilities', released in December 2014, will have the CNSC looking to facility operators to be compliant to the new standard. This paper will discuss initiatives at Canadian Nuclear Laboratories to develop of a suite of tools, techniques, and best practices that can be used by the regulator and industry for assessing compliance and effectiveness of cyber security technology and implementations. (author)

Cyber security - compliance to the new CSA 290.7 standard

Energy Technology Data Exchange (ETDEWEB)

Daley, M.; Doucet, R.; Echlin, M.; MacDonald, M.; Mihaylov, V.; Sijs, J.; Trask, D., E-mail: Matthew.Daley@cnl.ca [Canadian Nuclear Laboratories, Chalk River, ON, (Canada)

2015-07-01

Since 2008, the Canadian Nuclear Safety Commission (CNSC), similar to regulators of other critical industries, has requested their licensees to implement cyber security programs and conduct self-assessments without the benefit of an industry specific cyber security standard that provides common metrics for coverage and effectiveness of their programs. However, for the nuclear industry, a new CSA standard 290.7 entitled 'Cyber security for nuclear power plants and small reactor facilities' [1], released in December 2014, will have the CNSC looking to facility operators to be compliant to the new standard. This paper will discuss initiatives at Canadian Nuclear Laboratories to develop of a suite of tools, techniques, and best practices that can be used by the regulator and industry for assessing compliance and effectiveness of cyber security technology and implementations. (author)

Cyber security. Compliance to the new CSA 290.7 standard

International Nuclear Information System (INIS)

Daley, M.; Doucet, R.; Echlin, M.; MacDonald, M.; Mihaylov, V.; Sijs, J.; Trask, D.

2015-01-01

Since 2008, the Canadian Nuclear Safety Commission (CNSC), similar to regulators of other critical industries, has requested their licensees to implement cyber security programs and conduct self- assessments without the benefit of an industry specific cyber security standard that provides common metrics for coverage and effectiveness of their programs. However, for the nuclear industry, a new CSA standard 290.7 entitled 'Cyber security for nuclear power plants and small reactor facilities', released in December 2014, will have the CNSC looking to facility operators to be compliant to the new standard. This paper will discuss initiatives at Canadian Nuclear Laboratories to develop of a suite of tools, techniques, and best practices that can be used by the regulator and industry for assessing compliance and effectiveness of cyber security technology and implementations. (author)

Cyber security - compliance to the new CSA 290.7 standard

International Nuclear Information System (INIS)

Daley, M.; Doucet, R.; Echlin, M.; MacDonald, M.; Mihaylov, V.; Sijs, J.; Trask, D.

2015-01-01

Since 2008, the Canadian Nuclear Safety Commission (CNSC), similar to regulators of other critical industries, has requested their licensees to implement cyber security programs and conduct self-assessments without the benefit of an industry specific cyber security standard that provides common metrics for coverage and effectiveness of their programs. However, for the nuclear industry, a new CSA standard 290.7 entitled 'Cyber security for nuclear power plants and small reactor facilities' [1], released in December 2014, will have the CNSC looking to facility operators to be compliant to the new standard. This paper will discuss initiatives at Canadian Nuclear Laboratories to develop of a suite of tools, techniques, and best practices that can be used by the regulator and industry for assessing compliance and effectiveness of cyber security technology and implementations. (author)

Assessment of wastewater treatment facility compliance with decreasing ammonia discharge limits using a regression tree model.

Science.gov (United States)

Suchetana, Bihu; Rajagopalan, Balaji; Silverstein, JoAnn

2017-11-15

A regression tree-based diagnostic approach is developed to evaluate factors affecting US wastewater treatment plant compliance with ammonia discharge permit limits using Discharge Monthly Report (DMR) data from a sample of 106 municipal treatment plants for the period of 2004-2008. Predictor variables used to fit the regression tree are selected using random forests, and consist of the previous month's effluent ammonia, influent flow rates and plant capacity utilization. The tree models are first used to evaluate compliance with existing ammonia discharge standards at each facility and then applied assuming more stringent discharge limits, under consideration in many states. The model predicts that the ability to meet both current and future limits depends primarily on the previous month's treatment performance. With more stringent discharge limits predicted ammonia concentration relative to the discharge limit, increases. In-sample validation shows that the regression trees can provide a median classification accuracy of >70%. The regression tree model is validated using ammonia discharge data from an operating wastewater treatment plant and is able to accurately predict the observed ammonia discharge category approximately 80% of the time, indicating that the regression tree model can be applied to predict compliance for individual treatment plants providing practical guidance for utilities and regulators with an interest in controlling ammonia discharges. The proposed methodology is also used to demonstrate how to delineate reliable sources of demand and supply in a point source-to-point source nutrient credit trading scheme, as well as how planners and decision makers can set reasonable discharge limits in future. Copyright © 2017 Elsevier B.V. All rights reserved.

The EUR assessment process, methodology and highlights of the compliance analysis for the EU-APWR standard design - 15235

International Nuclear Information System (INIS)

Facciolo, L.; Welander, D.; Nuutinen, P.

2015-01-01

In August 2007 the European Utility Requirements organisation (EUR) received an initial application from Mitsubishi Heavy Industries asking for submitting the EU-APWR standard design to the EUR assessment. The EU-APWR is an advanced PWR, 1700 MWe class, 4-loops, 14 ft active core fuel length. The EU-APWR Standard Design documentation has been assessed against the EUR Volume 2 - Generic Nuclear Island requirements - Revision D. The assessment is divided into 20 chapters for a total of over 4000 individual requirements. A Synthesis Report for each chapter was written by the assessment performers. The Synthesis Reports showed that the EU-APWR Standard Design was in compliance with 77% of the EUR requirements. The percentage increases to 85% when taking into account the requirements where the design has been considered in compliance with the objectives. The requirements resulting in a non-compliance assessment correspond to less than 2%. This confirms the overall good level of compliance. From the Utilities point of view it is possible to state that the differences in standards, codes and regulations applied in Japan and in Europe contribute to a series of discrepancies between the EU-APWR Standard Design and the EUR, regarding, for instance, outage durations, operational capability, layout, personal protection or radiation monitoring. Some disagreements are easy to overcome, others require particular attention

Preventing nosocomial infections: improving compliance with standard precautions in an Indonesian teaching hospital.

NARCIS (Netherlands)

Duerink, D.O.; Farida, H.; Nagelkerke, N.J.; Wahyono, H.; Keuter, M.; Lestari, E.S.; Hadi, U.; Broek, P.J.J.A. van den

2006-01-01

Standard precautions can prevent transmission of micro-organisms. This study investigated hand hygiene, handling of needles and use of personal protective equipment in an Indonesian teaching hospital, and performed a multi-faceted intervention study to improve compliance. An intervention was

Current standards for infection control: audit assures compliance.

Science.gov (United States)

Flanagan, Pauline

Having robust policies and procedures in place for infection control is fundamentally important. However, each organization has to go a step beyond this; evidence has to be provided that these policies and procedures are followed. As of 1 April 2009, with the introduction of the Care Quality Commission and The Health and Social Care Act 2008 Code of Practice for the NHS on the Prevention and Control of Healthcare-Associated Infections and Related Guidance, the assurance of robust infection control measures within any UK provider of health care became an even higher priority. Also, the commissioning of any service by the NHS must provide evidence that the provider has in place robust procedures for infection control. This article demonstrates how the clinical audit team at the Douglas Macmillan Hospice in North Staffordshire, UK, have used audit to assure high rates of compliance with the current national standards for infection control. Prior to the audit, hospice staff had assumed that the rates of compliance for infection control approached 100%. This article shows that a good quality audit tool can be used to identify areas of shortfall in infection control and the effectiveness of putting in place an action plan followed by re-audit.

77 FR 25721 - Small Entity Compliance Guide: Bottled Water: Quality Standard: Establishing an Allowable Level...

Science.gov (United States)

2012-05-01

...] Small Entity Compliance Guide: Bottled Water: Quality Standard: Establishing an Allowable Level for di(2... ``Bottled Water: Quality Standard: Establishing an Allowable Level for di(2- ethylhexyl)phthalate--Small... an allowable level for di(2- ethylhexyl)phthalate (DEHP). This final rule is effective April 16, 2012...

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.

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

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

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

Compliance with Private Food Safety Standards among ...

International Development Research Centre (IDRC) Digital Library (Canada)

... and the livelihood impact of compliance. In addition, the project aims to build the capacity of farmers and other locally based actors to enhance compliance and thereby contribute to increased welfare in the project area. Expected outputs include one PhD thesis, five master's theses, and various journal publications and ...

Survey of Compliance with Radiation Protection Standards in Diagnostic Imaging Centers of Khuzestan Province in 2015

Directory of Open Access Journals (Sweden)

farshid mahmoudi

2017-03-01

rooms in 32 diagnostic imaging centers in Khuzestan Province, Iran, 2015. The centers were chosen through random cluster sampling method. The data were obtained using open-ended interview and a checklist designed based on the recommendations of the International Commission for Radiation Protection and Atomic Energy Organization of Iran. Results: The compliance rates with regard to radiology room, radiology equipment, darkroom, and radiographer’s protection were 80.76%, 80.47%, 69.28%, and 93.12%, respectively. Maximum and minimum rates of compliance with the standards were related to performance of the cassette tray (100% and hopper status (25%, respectively. Comparison of public and private imaging centers in terms of safety standards showed no significant differences (P>0.05.Conclusion: The observance of the radiation protection standards in Khuzestan Province was in a relativly desirable condition. However, there are some shortcomings in compliance with the principles of protection in the darkroom. In this regard, with recommend adopting protection measures such as timelyreplacement of processing solution, appropriate ventilation of darkroom, provisionof protection equipment and appliances, and protection training required for entering the darkroom.

Poor compliance with standard precautions against infections during minor gynaecological procedures.

Science.gov (United States)

Maharaj, Dushyant; Lawton, Beverley; Garrett, Sue

2012-06-01

Splash injuries occurring during minor surgical procedures are associated with a significant infective risk to the operator. It is a common misconception that minor operations carry low risks. To determine the prevalence of the practice of Standard Precautions by medical staff in the obstetric and gynaecology (O & G) units of two hospitals in New Zealand, and to assess self-observed splash injury rates. A cross-sectional survey of all doctors working in the O & G units of two public hospitals servicing a population of 435 000. A self-administered questionnaire was provided to 43 doctors with questions related to the use of Standard Precautions, perceived likelihood of infection from a splash and splash injuries sustained during procedures. The response rate was 76.6% (n = 33/43). Of the respondents, only 30.3% (n = 10) used Standard Precautions during minor procedures. Sixty-four per cent (n = 21) routinely used goggles/visor for eye protection. Forty-five per cent (n = 15) thought they were likely to get an infection from a splash, and 55% (n = 18) of clinicians had experienced a splash injury. Of the minor procedures during which splash injuries had occurred, repair of episiotomy 45.8% (n = 11) was the commonest. This survey shows poor compliance with guidelines for Standard Precautions to protect from infection despite self-reported rates of splash injury being high at 55%. Effective interventions are needed to increase compliance and prevent infection. © 2012 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Virtual reality for treatment compliance for people with serious mental illness.

Science.gov (United States)

Välimäki, Maritta; Hätönen, Heli M; Lahti, Mari E; Kurki, Marjo; Hottinen, Anja; Metsäranta, Kiki; Riihimäki, Tanja; Adams, Clive E

2014-10-08

Virtual reality (VR) is computerised real-time technology, which can be used an alternative assessment and treatment tool in the mental health field. Virtual reality may take different forms to simulate real-life activities and support treatment. To investigate the effects of virtual reality to support treatment compliance in people with serious mental illness. We searched the Cochrane Schizophrenia Group Trials Register (most recent, 17th September 2013) and relevant reference lists. All relevant randomised studies comparing virtual reality with standard care for those with serious mental illnesses. We defined virtual reality as a computerised real-time technology using graphics, sound and other sensory input, which creates the interactive computer-mediated world as a therapeutic tool. All review authors independently selected studies and extracted data. For homogeneous dichotomous data the risk difference (RD) and the 95% confidence intervals (CI) were calculated on an intention-to-treat basis. For continuous data, we calculated mean differences (MD). We assessed risk of bias and created a 'Summary of findings' table using the GRADE approach. We identified three short-term trials (total of 156 participants, duration five to 12 weeks). Outcomes were prone to at least a moderate risk of overestimating positive effects. We found that virtual reality had little effects regarding compliance (3 RCTs, n = 156, RD loss to follow-up 0.02 CI -0.08 to 0.12, low quality evidence), cognitive functioning (1 RCT, n = 27, MD average score on Cognistat 4.67 CI -1.76 to 11.10, low quality evidence), social skills (1 RCT, n = 64, MD average score on social problem solving SPSI-R (Social Problem Solving Inventory - Revised) -2.30 CI -8.13 to 3.53, low quality evidence), or acceptability of intervention (2 RCTs, n = 92, RD 0.05 CI -0.09 to 0.19, low quality evidence). There were no data reported on mental state, insight, behaviour, quality of life, costs, service utilisation, or

TREATMENT COMPLIANCE AMONG PATIENTS WITH CHRONIC PANCREATITIS IN THE MOSCOW REGION

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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

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

Tanning lamps ultraviolet emissions and compliance with technical standards

International Nuclear Information System (INIS)

Bonino, A.; Facta, S.; Saudino, S.; Anglesio, L.; D'Amore, G.

2009-01-01

In this work the compliance of tanning lamps with technical standards EN 60335-2-27 'Household and similar electrical appliances-Safety. Part 2: Particular requirements for appliances for skin exposure to ultraviolet and infrared radiation' was analysed. Results of this analysis showed that none of the examined technical documentation produced by the lamps manufacturers is fully compliant with the standard technique. Furthermore data reported in the same manuals, such as effective radiant exposure or irradiance, would indicate that these sources may be the cause of undue exposure to ultraviolet (UV) radiation. For this reason a measurement campaign on UV lamps used in tanning salons was organised. The first results of these measurements seem to confirm the doubts raised from the analysis of the lamp manuals: the use of a tanning lamp can lead to UV radiation exposure levels higher than reference maximum values recommended by EN 60335-2-27. (authors)

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.

Evaluating the Rate of Compliance with Radiation Protection Standards in Shohada Teaching Hospital -Tabriz

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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.

40 CFR 63.1585 - How does an industrial POTW treatment plant demonstrate compliance?

Science.gov (United States)

2010-07-01

... Works Industrial Potw Treatment Plant Description and Requirements § 63.1585 How does an industrial POTW treatment plant demonstrate compliance? (a) An existing industrial POTW treatment plant demonstrates... §§ 63.1586 through 63.1590. Non-industrial POTW Treatment Plant Requirements ...

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.

Effects of a mixed media education intervention program on increasing knowledge, attitude, and compliance with standard precautions among nursing students: A randomized controlled trial.

Science.gov (United States)

Xiong, Peng; Zhang, Jun; Wang, Xiaohui; Wu, Tat Leong; Hall, Brian J

2017-04-01

Standard precautions (SPs) are considered fundamental protective measures to manage health care-associated infections and to reduce occupational health hazards. This study intended to assess the effectiveness of a mixed media education intervention to enhance nursing students' knowledge, attitude, and compliance with SPs. A randomized controlled trial with 84 nursing students was conducted in a teaching hospital in Hubei, China. The intervention group (n = 42) attended 3 biweekly mixed media education sessions, consisting of lectures, videos, role-play, and feedback with 15-20 minutes of individual online supervision and feedback sessions following each class. The control group learned the same material through self-directed readings. Pre- and posttest assessments of knowledge, attitudes, and compliance were assessed with the Knowledge with Standard Precautions Questionnaire, Attitude with Standard Precautions Scale, and the Compliance with Standard Precautions Scale, respectively. The Standard Bacterial Colony Index was used to assess handwashing effectiveness. At 6-week follow-up, performance on the Knowledge with Standard Precautions Questionnaire, Attitude with Standard Precautions Scale, and Compliance with Standard Precautions Scale were significantly improved in the intervention group compared with the control group (P media education intervention is effective in improving knowledge, attitude, and compliance with SPs. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Tracer methodology: an appropriate tool for assessing compliance with accreditation standards?

Science.gov (United States)

Bouchard, Chantal; Jean, Olivier

2017-10-01

Tracer methodology has been used by Accreditation Canada since 2008 to collect evidence on the quality and safety of care and services, and to assess compliance with accreditation standards. Given the importance of this methodology in the accreditation program, the objective of this study is to assess the quality of the methodology and identify its strengths and weaknesses. A mixed quantitative and qualitative approach was adopted to evaluate consistency, appropriateness, effectiveness and stakeholder synergy in applying the methodology. An online questionnaire was sent to 468 Accreditation Canada surveyors. According to surveyors' perceptions, tracer methodology is an effective tool for collecting useful, credible and reliable information to assess compliance with Qmentum program standards and priority processes. The results show good coherence between methodology components (appropriateness of the priority processes evaluated, activities to evaluate a tracer, etc.). The main weaknesses are the time constraints faced by surveyors and management's lack of cooperation during the evaluation of tracers. The inadequate amount of time allowed for the methodology to be applied properly raises questions about the quality of the information obtained. This study paves the way for a future, more in-depth exploration of the identified weaknesses to help the accreditation organization make more targeted improvements to the methodology. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

13 CFR 107.700 - Compliance with size standards in part 121 of this chapter as a condition of Assistance.

Science.gov (United States)

2010-01-01

... Assistance SMALL BUSINESS ADMINISTRATION SMALL BUSINESS INVESTMENT COMPANIES Financing of Small Businesses by Licensees Determining the Eligibility of A Small Business for Sbic Financing § 107.700 Compliance with size... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Compliance with size standards in...

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.

Federal Facilities Compliance Act, Conceptual Site Treatment Plan. Part 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1993-10-29

This Conceptual Site Treatment Plan was prepared by Ames Laboratory to meet the requirements of the Federal Facilities Compliance Act. Topics discussed in this document include: general discussion of the plan, including the purpose and scope; technical aspects of preparing plans, including the rationale behind the treatability groupings and a discussion of characterization issues; treatment technology needs and treatment options for specific waste streams; low-level mixed waste options; TRU waste options; and future waste generation from restoration activities.

Predictors of low compliance with treatment in the patients with gastro-esophageal reflux disease

Directory of Open Access Journals (Sweden)

S. V. Tikhonov

2013-01-01

Full Text Available Gastroesophageal reflux disease is a widespread pathology requiring a long-term initial and maintaining therapy. Identification of the risk factors of low compliance of the patient with the treatment of the gastroesophageal reflux disease may be helpful in optimization of the patient - the doctor contact and thus may improve the compliance. The paper describes the predictors of low compliance that may be disclosed in the period of primary contact with the patients with gastroesophagial reflux pathology.

Safety standards for near surface disposal and the safety case and supporting safety assessment for demonstrating compliance with the standards

International Nuclear Information System (INIS)

Metcalf, P.

2003-01-01

The report presents the safety standards for near surface disposal (ICRP guidance and IAEA standards) and the safety case and supporting safety assessment for demonstrating compliance with the standards. Special attention is paid to the recommendations for disposal of long-lived solid radioactive waste. The requirements are based on the principle for the same level of protection of future individuals as for the current generation. Two types of exposure are considered: human intrusion and natural processes and protection measures are discussed. Safety requirements for near surface disposal are discussed including requirements for protection of human health and environment, requirements or safety assessments, waste acceptance and requirements etc

Compliance with dental treatment recommendations by rural paediatric patients after a live-video teledentistry consultation: A preliminary report.

Science.gov (United States)

McLaren, Sean W; Kopycka-Kedzierawski, Dorota T

2016-04-01

The purpose of this research was to assess the compliance rate with recommended dental treatment by rural paediatric dental patients after a live-video teledentistry consultation. A retrospective dental chart review was completed for 251 rural paediatric patients from the Finger Lakes region of New York State who had an initial teledentistry appointment with a paediatric dentist located remotely at the Eastman Institute for Oral Health in Rochester, NY. The recommended treatment modalities were tabulated and comprehensive dental treatment completion rates were obtained. The recommended treatment modality options of: treatment in the paediatric dental clinic; treatment using nitrous oxide anxiolysis; treatment with oral sedation; treatment in the operating room with general anaesthesia; or teleconsultation were identified for the 251 patients. Compliance rates for completed dental treatment based on initial teleconsultation recommendations were: 100% for treatment in the paediatric dental clinic; 56% for nitrous oxide patients; 87% for oral sedation; 93% for operating room; and 90% for teleconsultations. The differences in the compliance rates for all treatment modalities were not statistically significant (Fisher's exact test, p > 0.05). Compliance rates for completed comprehensive dental treatment for this rural population of paediatric dental patients were quite high, ranging from 56% to 100%, and tended to be higher when treatment was completed in fewer visits. Live-video teledentistry consultations conducted among rural paediatric patients and a paediatric dentist in the specialty clinic were feasible options for increasing dental treatment compliance rates when treating complex paediatric dental cases. © The Author(s) 2015.

'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.

Environmental effectiveness of GAEC cross-compliance standard 2.2 "Maintaining the level of soil organic matter through crop rotation" and economic evaluation of the competitiveness gap for farmers

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Lamberto Borrelli

2015-11-01

Full Text Available Within the Project MO.NA.CO was evaluated the Environmental effectiveness of GAEC cross-compliance standard 2.2 “Maintaining the level of soil organic matter through crop rotation” and economic evaluation of the competitiveness gap for farmers who support or not the cross-compliance regime. The monitoring was performed in nine experimental farms of the Council for Agricultural Research and Economics (CREA distributed throughout Italy and with different soil and climatic conditions. Were also evaluated the soil organic matter and some yield parameters, in a cereal monocropping (treatment counterfactual and a two-year rotation cereal-legume or forage (treatment factual. The two-years application of the standard “crop rotations” has produced contrasting results with regards to the storage of soil organic matter through crop rotation and these were not sufficient to demonstrate a statistically significant effect of treatment in any of the farms considered in monitoring, only in those farms subjected to more years of monitoring was recorded only a slight effect of the standard as a trend. The variations of organic matter in soils in response to changes in the culture technique or in the management of the soil may have long lag times and two years of time are not sufficient to demonstrate the dynamics of SOM associated with the treatment, also in consideration of the large inter annual variability recorded in different monitored sites.

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

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)

Compliance with the standards for prevention of ventilator-associated pneumonia by nurses in the intensive care units

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Saiede Masomeh Tabaeian

2017-01-01

Full Text Available Introduction: Ventilator-associated pneumonia (VAP is the most common infection in the intensive care unit, and has many side effects such as increased mortality, increased length of hospital stay, and increased health costs. This study aimed to evaluate the compliance with the standards for prevention of VAP by nurses in the intensive care units. Materials and Methods: In this descriptive cross-sectional study, 120 nurses in 11 intensive care units of hospitals affiliated to Isfahan university of Medical Sciences, Iran, were assessed for 4 months from July to October 2014. The implementation of all measures for the prevention of VAP was investigated through observation and using a checklist. Results: The mean compliance with the standards for the prevention of VAP in the intensive care unit by the nurses was 56.32%; analysis of variance test showed significant difference between the hospitals (P < 0.001. Disposable ventilator circuit was performed for all patients; however, reviewing the patient readiness for separation from the ventilator was not conducted on a daily basis. Conclusions: Compliance with the standards for the prevention of VAP in the intensive care units was relatively acceptable; however, it still requires serious attention by the officials with training and sensitization of nurses in implementing preventive measures, especially through the provision of clinical guidelines and related protocols.

Evaluation of emission characteristics and compliance of emission standards for in-use petrol driven vehicles in Delhi.

Science.gov (United States)

Sarin, S M; Singh, A; Sharma, N; Sharma, K; Shanmugum, P

2001-01-01

The tail pipe CO (carbon monoxide) and HC (hydrocarbon) emission characteristics of in-use petrol driven vehicles were evaluated between November 1996 through September 1997 in Delhi. A total of 4300 vehicles were checked at CRRI Pollution Checking Centre. Approximately 90% of the total vehicles meet the prescribed CO emission standards even without following routine I/M practices. The age of the vehicles appeared to have influence on the emission characteristics. The non-compliance level was found to be higher for older vehicles. Insignificant correlation was observed between CO and HC emissions for all categories of in-use petrol driven vehicles. The emission reduction (gain) in CO and HC emissions was observed for two wheelers equipped with four-stroke engines and four wheelers fitted with catalytic converters over their respective conventional vehicles. The observed high compliance levels indicate that existing tail pipe emission standards are lenient and need to be reviewed. The emission standards are proposed for different categories of in-use petrol driven vehicles.

Patient compliance and disease management in the treatment of psoriasis in the Netherlands

NARCIS (Netherlands)

van de Kerkhof, P. C.; de Hoop, D.; de Korte, J.; Cobelens, S. A.; Kuipers, M. V.

2000-01-01

Compliance behaviour and disease management are important issues in chronic skin diseases. Psoriasis patients are 'experts by experience' because of many years of treatment. Therefore, it is relevant to gather data from patients on the actual use of antipsoriatic treatments. The following questions

FACTORS AFFECTING THE COMPLIANCE OF MYANMAR NURSES IN PERFORMING STANDARD PRECAUTION

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Sa Sa Aung

2017-06-01

Full Text Available Introduction: Exposure to pathogens is a serious issue for nurses. The literature explains that standard precaution have not consistently done in nursing. The purpose of this study was to analyze the factors affecting the compliance of nurses in Myanmar in performing standard precautions. Methods: This study used a cross-sectional design. Samples included 34 nurses in Waibagi Specialist Hospital (SHW, Myanmar. The independent variables were the characteristics of nurses, knowledge of standard precaution, and exposure to blood / body fluids and needle puncture wounds. The dependent variable was the performance of standard prevention. Data analyzed using descriptive analysis and logistic regression. Results: The result showed that almost respondents (91.18% had a good knowledge about prevention standards and 73.5% of respondents had good adherence in performing standard precaution. However, in practice nurses have not been consistent in closing the needles that have been used correctly. The results showed that nurse characteristics did not significantly affect adherence to standard precaution with statistical test results as follows: age (p = 0.97, gender (p = 1.00, religion (p = 0.72, education (p = 0.85, work experience at SHW (p = 0, 84, education training program (p = 0.71, knowledge (p = 0.76, and needle stick injury (p = 0,17. But, there was a significant influence between adherence to standard precaution on the incidence of injury due to puncture needle with p value = 0.01. Discussion: The barriers to applying standard precautions by Myanmar nurses can be reduced by providing basic training, supervision and improvement of operational standard procedures.

Standard compliance - NDE performance demonstration/inspection in the CANDU industry

International Nuclear Information System (INIS)

Choi, E.

2011-01-01

CANDU nuclear power plants are operated in 3 provinces in Canada for electric power generation. A table in the paper will show the built and operating plants in Ontario, Quebec, New Brunswick and overseas. The regulator for nuclear power in Canada is the Canadian Nuclear Safety Commission (CNSC). The CNSC holds the plant licensees accountable for compliance to CSA N285.4 for periodic inspections. The Standard basically specifies the 'what, when, where, how, how much and how frequently' NDE is to be done on pressure retaining systems and components in CANDU nuclear power plants. In inspection methods, the Standard specifies they must be non-destructive. The NDE methods were grouped into visual, dimensional, surface, volumetric and integrative. The Standard also specifies that the licensees are responsible for the performance demonstration (PD) of the adequacy of the procedures and the proficiency of the personnel. This paper describes the Standard's requirement in NDE qualification and presents a joint project participated by Canadian and overseas CANDU owners. The sub-project for NDE included providing evidence and technical justification on the adequacy of the procedures and the proficiency of the personnel. The paper describes the qualification methodology followed by the participants. This will be followed by how the participants produced Inspection Specification, tools and procedures, personnel training and qualification programs, test and qualification samples, independent peer reviews and Technical Justification. (author)

Factors associated with compliance with community directed treatment with ivermectin for onchocerciasis control in Southwestern Ethiopia

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Wondafrash Mekite

2010-06-01

Full Text Available Abstract Background Although ivermectin is distributed free of charge through the African Programme for Onchocerciasis Control (APOC, not all eligible individuals within communities receive the annual treatment. This poses a serious threat to efforts aimed to control onchocerciasis. This study attempts to determine factors associated with compliance to Community Directed Treatment with Ivermectin (CDTI and provides a basis for trying to understand how best to sustain long-term compliance in order to achieve success in the control of onchocerciasis. Methods An unmatched case-control study was conducted in Bebeka coffee plantation southwest Ethiopia. Cases were, compliant i.e., those individuals who had been registered on the relevant treatment registers and had taken all the five annual doses of Ivermectin. Controls were non-compliant, i.e. those individuals who had been recorded in the relevant treatment registers during the first treatment round(2003, and did not take at least two doses of which one being in the last treatment round (2007. Data were collected using a pre-tested interviewer administered structured questionnaire. Data were edited, cleaned, coded and analyzed using SPSS version 12.0.1 for Microsoft Windows. Multiple logistic regression models was used to identify factors associated with compliance to ivermectin. Results From the total of 456 individuals selected for administration of the survey questionnaire, 450(225 cases and 225 controls were contacted and completed the study 2 refused and 4 were unavailable. Five factors associated with compliance were identified: high risk perception [Adjusted Odds Ratio(AOR = 1.98, 95% Confidence Interval (CI, 1.32-2.95], one's family support [AOR = 1.86, 95% CI, 1.22-2.84], perceiving that the Community Drug Distributors (CDDs are doing their work well [AOR = 2.84, 95% CI, 1.50-5.37] and perceiving measuring height is the best way to determine a person's treatment dose [AOR = 6.37, 95% CI, 2

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

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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.

Development of an assessment scale for treatment compliance in type 2 Diabetes Mellitus in Turkish population: Psychometric evaluation

Directory of Open Access Journals (Sweden)

Ayla Demirtaş

2017-07-01

Conclusion: The results of the study demonstrated that the scale with 30 items is a valid and reliable scale for the evaluation of patient compliance with type 2 DM treatment. Thus, by using this scale, nurses and healthcare providers can evaluate the treatment compliance of patients with type 2 DM.

Nonremovable, windowed, fiberglass cast boot in the treatment of diabetic plantar ulcers: efficacy, safety, and compliance.

Science.gov (United States)

Ha Van, Georges; Siney, Hubert; Hartmann-Heurtier, Agnes; Jacqueminet, Sophie; Greau, Françoise; Grimaldi, André

2003-10-01

To compare the efficacy, safety, and compliance of a nonremovable fiberglass cast boot and off-loading shoes in the treatment of diabetic plantar ulcers. Patients (n = 93) with noninfected, nonischemic plantar ulcers were included in this prospective nonrandomized study. Treatment used a nonremovable fiberglass cast boot for longer standing and deeper ulcers (n = 42) and a half shoe or heel-relief shoe for other ulcers (n = 51). We evaluated off-loading therapy, compliance, and complications in both groups. The healing rate was significantly higher with the cast boot than with the off-loading shoe (81 vs. 70%, P = 0.017), with healing times of 68.6 +/- 35.1 vs. 134.2 +/- 133.0 days, respectively, and hazard ratio 1.68 (95% CI 1.04-2.70); complete compliance with treatment was 98 vs. 10% (P = 0.001), respectively. Secondary osteomyelitis developed in 3 patients in the cast boot group and 13 patients in the off-loading shoe group (P = 0.026). A nonremovable fiberglass cast boot was effective in healing diabetic plantar ulcers and in decreasing the risk of secondary osteomyelitis. The cast boot forced compliance with off-loading, thus promoting healing.

Ballast water compliance monitoring: A new application for ATP

Science.gov (United States)

Lo Curto, A.; Stehouwer, P.; Gianoli, C.; Schneider, G.; Raymond, M.; Bonamin, V.

2018-03-01

The coming into force of the USCG ballast water regulations and the IMO ballast water management convention resulted in the development of several technologies approved for the treatment of ballast water. To ensure compliance of these technologies, the development of rapid and robust analysis methods was necessary. In collaboration with the SGS Group (Switzerland) and LuminUltra (Canada), Aqua-tools (France) has developed an innovative Ballast Water Treatment Monitoring (BWTM) kit for rapid onboard testing. The affordable kit provides results in less than 1 h, is easy to use and durable ensuring that the ballast water treatment system on the ship is fully compliant with the discharge standards upon arrival in port. The core of this method is a combination of high-quality reagents (lysis solution and ATP 2G Luminase™ enzyme) not inhibited by salinity and a patented fast homogenizing method for ATP extraction developed for a higher ATP recovery from zooplankton and phytoplankton. Compared to traditional analysis methods, the BWTM Kit provides fast and accurate results for all three fractions of microorganisms (≥ 50 μm, ≥ 10 ÷ < 50 μm and bacteria). Preliminary tests carried out in cooperation with SGS showed that the proposed method was able to detect onboard the efficiency of the treatment systems used. Compliance limits were established for all size fractions and a correlation between the standard methods (microscopy, plate count, MPN) and ATP was evaluated. The BWTM kit can provide a fast indication of compliance or gross exceedance. The rare borderline cases, when encountered, of course require additional confirmation.

[Treatment compliance with continuous positive airway pressure device among adults with obstructive sleep apnea (OSA): how many adhere to treatment?].

Science.gov (United States)

Sarrell, E Michael; Chomsky, Ofer; Shechter, Dalia

2013-03-01

Obstructive sleep apnea syndrome (OSA) afflicts approximately 5% of the adult population and increases with age. The gold standard treatment is with the Continuous Positive Airways Pressure (CPAP) machine. Well-designed prospective trials to elucidate long term compliance with CPAP machine are rare. Assessing compliance and long-term use of CPAP machines among patients with OSA who were referred for treatment with this machine. A 4 years prospective cohort observational study was conducted using telephone interviews of 371 newly diagnosed patients with moderate to severe OSA, who received a specialist recommendation to use the CPAP machine which was bought and adjusted to their use. At the end of the first year, 126 (34%) of the OSA patients used the CPAP machine on a nightly basis (regular users), 120 (32.3%) had not used it at all, and 125 (33.7%) had used it only intermittently. The number of regular users increased between the 1st and 2nd year from 126 (34%), to 163 (44%) (p < 0.07) due to additions from the intermittent users group. The non-users group grew from 120 (32.3%) in the first year, and every year afterwards, up to 221 (59.6%) in the fourth year (p < 0.02). In contrast, there was a significant decrease in the intermittent users group, which declined from 125 (33.7%) in the first year to only 18 (4.8%) in the 4th year (p < 0.005). Most of the patients (92.9%) were males. The average age of the regular users was 59.6 years (+/- 11), which was higher in comparison to 55.9 years (+/- 10.3) for the non-users or 58.9 years (+/- 12.6) among the intermittent users (p = 0.064). There were no statistical differences in co-morbidities or demographics between the three groups. However, the regular users were found to have a higher score in the Epworth Sleepiness Scale (ESS) and a minimal arterial oxygen saturation (SaO2) level lower than the patients in the non-users and intermittent users groups (p = 0.019 and p = 0.03 respectively). Four years follow

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

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.

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...

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....

Compliance of the legal treatment of experimental animals in Serbian legislation with the legislation of the European Union

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Vidić-Trninić Jelena

2013-01-01

Full Text Available The author focuses on compliance of the legal treatment of experimental animals in Serbian law with the provisions of the European legislation. Analysing, on one hand, the treatment that experimental animals have under the law of European Union, and on the other hand, the treatment that they have in the law of Serbia, in accordance with the relevant acts and subordinate legislation acts, this article seeks to answer the question whether the degree of legal protection of experimental animals in domestic law is satisfactory, as well as whether and to what extent the relevant national legislation complies with the European standards. At the same time, the article attempts to point out the appropriate measures necessary to be taken in the future in order to achieve as high quality and comprehensive protection of experimental animals as possible in Serbian law.

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.

Federal Facility Compliance Act, Proposed Site Treatment Plan: Background Volume. Executive Summary

International Nuclear Information System (INIS)

1995-01-01

This Federal Facility Compliance Act Site Treatment Plan discusses the options of radioactive waste management for Ames Laboratory. This is the background volume which discusses: site history and mission; framework for developing site treatment plans; proposed plan organization and related activities; characterization of mixed waste and waste minimization; low level mixed waste streams and the proposed treatment approach; future generation of TRU and mixed wastes; the adequacy of mixed waste storage facilities; and a summary of the overall DOE activity in the area of disposal of mixed waste treatment residuals

Compliance with adjuvant treatment guidelines in endometrial cancer: room for improvement in high risk patients.

Science.gov (United States)

Eggink, F A; Mom, C H; Boll, D; Ezendam, N P M; Kruitwagen, R F P M; Pijnenborg, J M A; van der Aa, M A; Nijman, H W

2017-08-01

Compliance of physicians with guidelines has emerged as an important indicator for quality of care. We evaluated compliance of physicians with adjuvant therapy guidelines for endometrial cancer patients in the Netherlands in a population-based cohort over a period of 10years. Data from all patients diagnosed with endometrial cancer between 2005 and 2014, without residual tumor after surgical treatment, were extracted from the Netherlands Cancer Registry (N=14,564). FIGO stage, grade, tumor type and age were used to stratify patients into risk groups. Possible changes in compliance over time and impact of compliance on survival were assessed. Patients were stratified into low/low-intermediate (52%), high-intermediate (21%) and high (20%) risk groups. Overall compliance with adjuvant therapy guidelines was 85%. Compliance was highest in patients with low/low-intermediate risk (98%, no adjuvant therapy indicated). The lowest compliance was determined in patients with high risk (61%, external beam radiotherapy with/without chemotherapy indicated). Within this group compliance decreased from 64% in 2005-2009 to 57% in 2010-2014. In high risk patients with FIGO stage III serous disease compliance was 55% (chemotherapy with/without radiotherapy indicated) and increased from 41% in 2005-2009 to 66% in 2010-2014. While compliance of physicians with adjuvant therapy guidelines is excellent in patients with low and low-intermediate risk, there is room for improvement in high risk endometrial cancer patients. Eagerly awaited results of ongoing randomized clinical trials may provide more definitive guidance regarding adjuvant therapy for high risk endometrial cancer patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Knowledge of stakeholders in the game meat industry and its effect on compliance with food safety standards.

Science.gov (United States)

Bekker, Johan Leon; Hoffman, Louw C; Jooste, Piet J

2011-10-01

The game meat industry is continuing to grow in South Africa. Several stakeholders are involved in the game meat supply chain and a high level of knowledge is necessary to ensure compliance with legislation and standards. It was therefore necessary to determine the level of knowledge of the stakeholders since this has not been determined before. Information regarding the extent of stakeholders' knowledge and the possible impact on compliance to standards was obtained through a desk-top study and an analysis of questionnaire responses from industry, consumers and relevant authorities. Results have shown that consumers have a specific expectation regarding the safe production of game meat. Limitations in the knowledge of the stakeholders have been identified. Understanding these limitations can assist policy-makers, law enforcers and the game meat industry in developing strategies to alleviate the problem. The result of this study may assist in providing consumers with game meat that is safe for human consumption.

Compliance with infection control standard precautions guidelines: a survey among dental healthcare workers in Hail Region, Saudi Arabia.

Science.gov (United States)

Haridi, Hassan Kasim; Al-Ammar, Abdalmohsen Saud; Al-Mansour, Moazzy Ibraheim

2016-11-01

The concept of standard precautions (SP) has been a cornerstone of dental infection control (IC) practice. Full adherence with SP guidelines is still a matter of concern in many institutions. The objectives of the present study were to assess and characterise compliance with SP guidelines among dental healthcare workers (DHCWs) and to analyse factors that affect compliance. A regional cross-sectional questionnaire survey among DHCWs in all health facilities was carried out from August to November 2014. A total of 307 returned valid self-report questionnaires with a response rate of 73.1%. Most participants (86.3%) were aware of the SP guidelines, 84.4% received IC training and 88.9% received hepatitis B vaccination. Compliance with SP was found to be high; the majority (90.1%) attained 75% on the compliance scale. In the multivariate logistic regression model, perceived higher institutional commitment as regard IC requirements (odds ratio [OR], 4.34; P guidelines. Institutional factors appear to have an important role. Attention should be paid to dental assistants and private DHCWs.

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.

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

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...

Pragmatics of policy: the compliance of dutch environmental policy instruments to European union standards.

Science.gov (United States)

Kruitwagen, Sonja; Reudink, Melchert; Faber, Albert

2009-04-01

Despite a general decrease in Dutch environmental emission trends, it remains difficult to comply with European Union (EU) environmental policy targets. Furthermore, environmental issues have become increasingly complex and entangled with society. Therefore, Dutch environmental policy follows a pragmatic line by adopting a flexible approach for compliance, rather than aiming at further reduction at the source of emission. This may be politically useful in order to adequately reach EU targets, but restoration of environmental conditions may be delayed. However, due to the complexity of today's environmental issues, the restoration of environmental conditions might not be the only standard for a proper policy approach. Consequently this raises the question how the Dutch pragmatic approach to compliance qualifies in a broader policy assessment. In order to answer this question, we adapt a policy assessment framework, developed by Hemerijck and Hazeu (Bestuurskunde 13(2), 2004), based on the dimensions of legitimacy and policy logic. We apply this framework for three environmental policy assessments: flexible instruments in climate policy, fine-tuning of national and local measures to meet air quality standards, and derogation for the Nitrate Directive. We conclude with general assessment notes on the appliance of flexible instruments in environmental policy, showing that a broad and comprehensive perspective can help to understand the arguments to put such policy instruments into place and to identify trade-offs between assessment criteria.

Economic competitiveness gap related to the application of the GAEC standards of cross-compliance on farms: evaluation methodology

Directory of Open Access Journals (Sweden)

Marco Fedrizzi

2015-12-01

Full Text Available This paper describes the methods used in the monitoring carried out in the farms of the MO.NA.CO. project, to calculate the economic competitiveness gap faced by agricultural holdings that accede to the commitments imposed by the standards included in the project. The monitoring works were performed in agricultural holdings in relation to the particular reference condition of each standard. The processing of the information acquired allowed us to define the working times of each cultivation operation by means of the indications in the recommendations of the Associazione Italiana di Genio Rurale - Italian Rural Engineering Association, that considers the official methodology of the International Commission of the Organisation Scientifique du Travail en Agriculture (C.I.O.S.T.A.. The overall costs and revenues in case of compliance or non-compliance with the commitments of the standard were calculated by using Biondi’s methodology and other norms that indicate the technical and economic coefficients to be used in the calculations (EP 496.2 and D 497.4 ASAE standards. With the data related to the unit cost of ploughing a model Partial Least Squares (PLS has been achieved and validated, and it makes possible to predict the unit cost of this agricultural operation. Finally, the values of the variation of the economic competitiveness gap are reported for each standard.

Frequent Evaluation To Improve Compliance In Patients Treated With Occlusion For Amblyopia: A Randomized controlled Trial.

Science.gov (United States)

Iturriaga, Hernan; Zanolli, Mario; Damm, Constanza; Oporto, Jorge; Acuna, Olga; Valenzuela, Felipe

2012-01-01

The benefits of occlusion treatment for amblyopia are well established.True compliance can be difficult to assess and is usually based on patient history. We hypothesize that more visits to the physician provides more chances to improve compliance. We conducted a prospective, comparative, blind trial in which 30 children with amblyopia were randomly assigned to be followed up more frequently (every 4 to 6 weeks) (study group) or as established on our standard regular basis (month intervals based on age in years) (control group). The primary outcome was to study differences in treatment compliance between these groups. The secondary outcome was to report compliance in a group of Chilean children and to compare survey results with adherence, to assess concordance between them. Baseline clinical characteristics were similar in the two groups. 30 patients were recruited. Mean compliance for all patients was 82%. Study group compliance was 83% versus 76% in control group (p = 0.5). Without epidemiology, intention to treat analysis (ITT), study group compliance was 97% compared to 76% in control group (p = 0.049). Pearson correlation between negative responses to a parental survey after treatment, of the percentage of adherence and compliance, was -0.57 and statistically significant (p = 0.013). There were no differences in patient compliance comparing more frequent evaluation versus a follow up evaluation based in an age according scheme. There is a high compliance to occlusion therapy in this group of Chilean children. If parents reported more negative adherence aspects in the survey, the worse the compliance.

The theory of reasoned action and patient compliance during orthodontic treatment.

Science.gov (United States)

Bos, Annemieke; Hoogstraten, Johan; Prahl-Andersen, Birte

2005-12-01

The aim of the present study was to investigate the potential of the theory of reasoned action (TRA) for the prediction and understanding of patients' intention to comply during orthodontic treatment and to analyze the effect of two additional variables in the model, namely perceived behavioral control and anticipated regret. Moreover, (the determinants of) intentions of orthodontic patients to comply during treatment were compared with (the determinants of) intentions of parents to stimulate this cooperation. A questionnaire was handed out to patients and parents visiting the Department of Orthodontics of the Academic Centre of Dentistry in Amsterdam. In both the patient and parent sample, independent-sample t-tests, correlation analyses and stepwise regression analyses were conducted. Variables in both samples were compared and tested. The extended version of the TRA explained 20% of the variance in the patients' intention to comply. The patients' anticipated regret, attitude and motivation to comply were significant determinants of the patients' intention to comply. In addition, the parents' attitude toward compliance was a significant predictor. The role of parents in enhancing patients' intentions to comply cannot be neglected. Our findings suggest that patients' intentions to comply during orthodontic treatment are influenced by factors outside of the TRA. Therefore, it is recommended to develop a new model, in which factors of the TRA are included, which can be used specifically for the study of compliance in orthodontics.

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

Fuel price impacts and compliance costs associated with the Renewable Fuel Standard (RFS)

International Nuclear Information System (INIS)

Christensen, Adam; Siddiqui, Sauleh

2015-01-01

US policy instruments concerning vehicle biofuels are currently being revisited. For example, as part of an on-going annual Renewable Fuel Standard (RFS) implementation, the Environmental Protection Agency (EPA) requests stakeholder feedback/analysis of programmatic effects, including impacts on gasoline/diesel prices and compliance costs. Motivated by the need for regulatory-specific feedback, a novel regional market model is developed that quantifies price impacts across different regional markets for a number of market variables, including several types of compliance certificates known as Renewable Identification Numbers (RINs). An analysis of the most recent EPA proposal suggests that the D4 (biodiesel) RIN price could rise to >$1.00/RIN. Sensitivity results show that the D4 RIN price is highly sensitive to soybean oil prices, while D5/D6 RIN prices are most sensitive to the volume of E85 consumed. It was found that the projected costs associated with the RFS in 2017 could be reduced by approximately 50% if an additional 600 million gallons of E85 were consumed. The analysis also suggests that the RFS does not dramatically affect the retail price of either gasoline and diesel fuels paid by consumers. - Highlights: • The most recent EPA could cause the biodiesel RIN price to rise to >$1.00/RIN. • D5/D6 RIN prices are most sensitive to the volume of E85 consumed. • Retail prices for fuel do not change dramatically. • 2017 compliance costs could fall by 50% if more E85 were consumed.

THE PRECAUTIONARY PROCEDURES IN THE CASE OF NON-COMPLIANCE WITH THE BALLAST WATER MANAGEMENT CON-VENTION’S STANDARDS – POSSIBLE SOLUTIONS FOR POLISH PORTS

Directory of Open Access Journals (Sweden)

Magdalena Klopott

2016-12-01

Full Text Available On September 8, 2017 the International Convention for the Control and Manage-ment of Ships’ Ballast Water and Sediments (BWMC adopted in 2004 will enter into force. It imposes a lot of requirements on shipowners and port states. The aim of this article is to elaborate on the possible solutions that may be adopted in Polish ports as precau-tionary measures in the case of non-compliance with the provisions of BWMC. The article starts with a brief overview of BWMC and ballast water quality stand-ards. Further, it discusses the possible implications of not meeting the ballast water quality standards under BWMC. The elaboration of potential solutions and mitigation measures in the event of non-compliance with the BWMC constitutes the main part of the article. These are crucial to developing a port contingency plan and include, for example, shore-based reception facility for ballast water, mobile ballast water treatment systems, and using potable water. The article ends with a brief analysis of a possible fee systems for reception of ballast water. The research was based on a comprehensive analysis of the Convention and related legal documents, interviews with ports’ representatives as well as e-mail interviews with maritime authorities in the Baltic Sea countries.

Compliance with preventive care following dental treatment of children under general anaesthesia.

Science.gov (United States)

Peerbhay, F B M

2009-11-01

This study evaluated the self-reported preventive dental care compliance of parents/families whose children received dental treatment under general anaesthesia. Complete records of 68 pediatric patients who attended the University of Stellenbosch's Paediatric Dentistry Department for dental treatment were included in the survey. Parents of 41 (60%) patients were interviewed telephonically to evaluate parental dental health knowledge and preventive practices. The majority (85%) of parents had a good idea about the aetiology of dental caries. An assessment of the children's dental health behaviour reveals that parents were mostly responsible for brushing the childs' teeth (44%).The majority of parents (51%) reported that following dental treatment of the child under general anaesthesia, there was no change in their child's frequency of sugar consumption. Sixty-three percent of children treated under GA had returned for the one-week follow-up. However, only 22% of children returned for the three-month follow up appointment. Parents were informed about the importance of these follow-up appointments. Parental belief that proper dental health behaviour helps maintain the teeth, did not influence parents preventive compliance, despite them having received preventive instruction. Parents were mostly responsible for brushing their child's teeth following dental treatment of their children under general anaesthesia. This research found however that, in the majority of cases there was no change in the children's frequency of sugar intake.

Cultural Adaptation and Reliability of the Compliance with Standard Precautions Scale (CSPS) for Nurses in Brazil 1

Science.gov (United States)

Pereira, Fernanda Maria Vieira; Lam, Simon Ching; Gir, Elucir

2017-01-01

ABSTRACT Objective: this study aimed to carry of the cultural adaptation and to evaluate the reliability of the Compliance with Standard Precautions Scale (CSPS) for nurses in Brazil. Method: the adaptation process entailed translation, consensus among judges, back-translation, semantic validation and pretest. The reliability was evaluated by internal consistency (Cronbach alpha) and stability (test-retest). The instrument was administered to a sample group of 300 nurses who worked in a large hospital located in the city of São Paulo/SP, Brazil. Results: through the semantic validation, the items from the scale were considered understandable and deemed important for the nurse´s clinical practice. The CSPS Brazilian Portuguese version (CSPS-PB) revealed excellent interpretability. The Cronbach`s alpha was 0.61 and the intraclass correlation coefficient was 0.85. Conclusion: the initial study showed that CSPS-PB is appropriate to assess compliance with standard precautions among nurses in Brazil. The reliability was considered acceptable. Furhter study is necessary to evaluate its comprehensive psychometric properties. PMID:28301030

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

Moving beyond Compliance: Promoting Research-Based Professional Discretion in the Implementation of the Common Core State Standards in English Language Arts

Science.gov (United States)

Woodard, Rebecca; Kline, Sonia

2015-01-01

State- and local-level mandates are currently being implemented to ensure strict compliance to the new national Common Core State Standards for English Language Arts (CCSS for ELA) and related assessments. These standards provide many potential opportunities to improve literacy education nationally and locally. However, the CCSS for ELA will…

[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.

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.

Assessment of compliance costs resulting from implementation of the proposed Great Lakes water quality guidance

International Nuclear Information System (INIS)

Fenner, K.; Podar, M.; Snyder, B.

1993-01-01

The primary purpose of the study was to develop an estimate of the incremental cost to direct dischargers resulting from the implementation of the proposed Great Lakes Water Quality Guidance (GLWQG). This estimate reflects the incremental cost of complying with permit requirements developed using the Implementation Procedures and water quality criteria proposed in the GLWQG versus permit requirements based on existing State water quality standards. Two secondary analyses were also performed, one to develop a preliminary estimate of the costs that would be incurred by indirect dischargers to publicly owned treatment works (POTWs), and another to evaluate the cost-effectiveness of the GLWQG. Finally, several sensitivity analyses were performed to evaluate the impact of several major assumptions on the estimated compliance costs. To estimate compliance costs, permit limitations and conditions based on existing State water quality standards were compared to water quality-based limitations and conditions based on the proposed GLWQG criteria and Implementation Procedures for a sample of plants. The control measures needed to comply with the proposed GLWQG-based effluent limitations were evaluated. Individual plant compliance costs were estimated for these control measures based on information on treatment technology and cost analyses available in the literature. An overall compliance cost was projected from the sample based on statistical methods

Information and communication technology based prompting for treatment compliance for people with serious mental illness.

Science.gov (United States)

Kauppi, Kaisa; Välimäki, Maritta; Hätönen, Heli M; Kuosmanen, Lauri M; Warwick-Smith, Katja; Adams, Clive E

2014-06-17

Non-compliance is a significant problem among people with serious mental disorders, presenting a challenge for mental health professionals. Prompts such as telephone calls, visits, and a posted referral letter to patients are currently used to encourage patient attendance at clinics and/or compliance with medication. More recently, the use of information and communication technology (ICT)-based prompting methods have increased. Methods include mobile text message (SMS - short message service), e-mail or use of any other electronic device with the stated purpose of encouraging compliance. To investigate the effects of ICT-based prompting to support treatment compliance in people with serious mental illness compared with standard care. We searched the Cochrane Schizophrenia Group's Trials Register (31(st) May 2011 and 9(th) July 2012) which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO, and registries of clinical trials. Also, we inspected references of all identified studies for further trials and contacted authors of trials for additional information. Relevant randomised controlled trials involving adults with serious mental illness, comparing any ICT-based prompt or combination of prompts by automatic or semi-automatic system compared with standard care. Review authors reliably assessed trial quality and extracted data. We calculated risk ratio (RR) with 95% confidence intervals (CI) using a fixed-effect model. For continuous outcomes, we estimated the mean difference (MD) between groups, again with 95% confidence intervals. A 'Summary of findings' table using GRADE was created, and we assessed included studies for risk of bias. The search identified 35 references, with 25 studies, but we could only include two studies with a total of 358 participants. The studies had a moderate risk of bias, and therefore risk overestimating any positive effects of ICT-based prompting. Both included studies compared semi-automatised ICT

Binocular versus standard occlusion or blurring treatment for unilateral amblyopia in children aged three to eight years.

Science.gov (United States)

Tailor, Vijay; Bossi, Manuela; Bunce, Catey; Greenwood, John A; Dahlmann-Noor, Annegret

2015-08-11

to enrolment, participants were to have undergone a cycloplegic refraction and comprehensive ophthalmic examination including fundal examination. In addition, participants had to have completed a period of optical treatment, if indicated, and BCVA in the amblyopic eye had to remain unchanged on two consecutive assessments despite reportedly good compliance with glasses wearing. Participants were not to have received any treatment other than optical treatment prior to enrolment. We planned to include any type of binocular viewing intervention; these could be delivered on different devices including computer monitors viewed with LCD shutter glasses or hand-held screens including mobile phone screens with lenticular prism overlay. Control groups were to have received standard amblyopia treatment; this could include occlusion or pharmacological blurring of the better-seeing eye. We planned to include full-time (all waking hours) and part-time (between 1 and 12 hours a day) occlusion regimens. We planned to use standard methodological procedures expected by The Cochrane Collaboration. We had planned to meta-analyse the primary outcome, that is mean distance BCVA in the amblyopic eye at 12 months after the cessation of treatment. We could identify no RCTs in this subject area. Further research is required to allow decisions about implementation of binocular treatments for amblyopia in clinical practice. Currently there are no clinical trials offering standardised evidence of the safety and effectiveness of binocular treatments, but results from non-controlled cohort studies are encouraging. Future research should be conducted in the form of RCTs, using acknowledged methods of visual acuity and stereoacuity assessment with known reproducibility. Other important outcome measures include outcomes reported by users, compliance with treatment, and recurrence of amblyopia after cessation of treatment.

Bifidobacterium lactis B94 plus inulin for Treatment of Helicobacter pylori infection in children: does it increase eradication rate and patient compliance?

Science.gov (United States)

Islek, A; Sayar, E; Yilmaz, A; Artan, R

2015-01-01

The aim of this study is to investigate the effects of Bifidobacterium lactis B94 and inulin (synbiotic) treatment on eradication rate and patient compliance in subjects treated for symptomatic H. pylori infection. Patients with symptomatic H. pylori infection were divided into two groups. One group was treated with standard triple therapy (lansoprazole, amoxicillin, and clarithromycin) and B. lactis B94 (5 × 109 CFU/dose) plus inulin (900 mg) twice daily for seven days. The control group was treated with standard triple therapy and placebo. The side effects and eradication rates were evaluated at the end of the study. Ninety-three patients with H. pylori infection were treated with either synbiotic plus triple therapy (n = 47) or placebo plus triple therapy (n = 46). The infection eradication rates were not significantly different between the synbiotic and placebo groups [intent-to-treat (ITT), 80.8% and 67.3%, p = 0.13, respectively; per-protocol (PP), 86.3% and 81.5%, p = 0.55, respectively]. The drug side effects were significantly higher in the placebo group than in the synbiotic group (63% and 17%, respectively, p < 0.01). Although no intolerable adverse side effects were observed in the synbiotic group, intolerable adverse side effects were observed in 13% of the placebo group (p = 0.01). Our results suggest that twice daily 5 × 109 CFU/dose B. lactis B94 plus 900 mg inulin treatment did not have a direct positive effect on the H. pylori eradication rate. However, this treatment had significantly reduced side effects and indirectly increased eradication rates by increasing patient compliance. © Acta Gastro-Enterologica Belgica.

Implementing an integrated standards-based management system to ensure compliance at Los Alamos National Laboratory

International Nuclear Information System (INIS)

Hjeresen, D.; Roybal, S.; Bertino, P.; Gherman, C.; Hosteny, B.

1995-01-01

Los Alamos National Laboratory (LANL or the Laboratory) is developing and implementing a comprehensive, Integrated Standards-Based Management System (ISBMS) to enhance environmental, safety, and health (ESH) compliance efforts and streamline management of ESH throughout the Laboratory. The Laboratory recognizes that to be competitive in today's business environment and attractive to potential Partnerships, Laboratory operations must be efficient and cost-effective. The Laboratory also realizes potential growth opportunities for developing ESH as a strength in providing new or improved services to its customers. Overall, the Laboratory desires to establish and build upon an ESH management system which ensures continuous improvement in protecting public health and safety and the environment and which fosters a working relationship with stakeholders. A team of process experts from the LANL Environmental Management (EM) Program Office, worked with management system consultants, and the Department of Energy (DOE) to develop an ESH management systems process to compare current LANL ESH management Systems and programs against leading industry standards. The process enabled the Laboratory to gauge its performance in each of the following areas: Planning and Policy Setting; Systems and Procedures; Implementation and Education; and Monitoring and Reporting. The information gathered on ESH management systems enabled LANL to pinpoint and prioritize opportunities for improvement in the provision of ESH services throughout the Laboratory and ultimately overall ESH compliance

40 CFR 63.1203 - What are the standards for hazardous waste incinerators that are effective until compliance with...

Science.gov (United States)

2010-07-01

... (POHCs) in the waste feed that you specify under paragraph (c)(3)(ii) of this section to the extent... hazardous waste and on their concentration or mass in the hazardous waste feed, considering the results of... waste incinerators that are effective until compliance with the standards under § 63.1219? 63.1203...

Basis to demonstrate compliance with the National Emission Standards for Hazardous Air Pollutants for the Stand-off Experiments Range

Energy Technology Data Exchange (ETDEWEB)

Michael Sandvig

2011-01-01

The purpose of this report is to provide the basis and the documentation to demonstrate general compliance with the National Emission Standard for Hazardous Air Pollutants (NESHAPS) 40 CFR 61 Subpart H, “National Emission Standards for Emissions of Radionuclides Other Than Radon from Department of Energy Facilities,” (the Standard) for outdoor linear accelerator operations at the Idaho National Laboratory (INL) Stand-off Experiments Range (SOX). The intent of this report is to inform and gain acceptance of this methodology from the governmental bodies regulating the INL.

Response to "Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study"

NARCIS (Netherlands)

de Jongh, A.; ten Broeke, E.

2014-01-01

Last November, the European Journal of Psychotraumatology published an interesting paper entitled "Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study". This article

Evaluation of the WIPP Project's compliance with the EPA radiation protection standards for disposal of transuranic waste

International Nuclear Information System (INIS)

Neill, R.H.; Chaturvedi, L.; Rucker, D.F.; Silva, M.K.; Walker, B.A.; Channell, J.K.; Clemo, T.M.

1998-03-01

The US Environmental Protection Agency's (EPA) proposed rule to certify that the Waste Isolation Pilot Plant (WIPP) meets compliance with the long-term radiation protection standards for geologic repositories (40CFR191 Subparts B and C), is one of the most significant milestones to date for the WIPP project in particular, and for the nuclear waste issue in general. The Environmental Evaluation Group (EEG) has provided an independent technical oversight for the WIPP project since 1978, and is responsible for many improvements in the location, design, and testing of various aspects of the project, including participation in the development of the EPA standards since the early 1980s. The EEG reviewed the development of documentation for assessing the WIPP's compliance by the Sandia National Laboratories following the 1985 promulgation by EPA, and provided many written and verbal comments on various aspects of this effort, culminating in the overall review of the 1992 performance assessment. For the US Department of Energy's (DOE) compliance certification application (CCA), the EEG provided detailed comments on the draft CCA in March, 1996, and additional comments through unpublished letters in 1997 (included as Appendices 8.1 and 8.2 in this report). Since the October 30, 1997, publication of the EPA's proposed rule to certify WIPP, the EEG gave presentations on important issues to the EPA on December 10, 1997, and sent a December 31, 1997 letter with attachments to clarify those issues (Appendix 8.3). The EEG has raised a number of questions that may have an impact on compliance. In spite of the best efforts by the EEG, the EPA reaction to reviews and suggestions has been slow and apparently driven by legal considerations. This report discusses in detail the questions that have been raised about containment requirements. Also discussed are assurance requirements, groundwater protection, individual protection, and an evaluation of EPA's responses to EEG's comments

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

Topical nasal steroid treatment does not improve CPAP compliance in unselected patients with OSAS.

Science.gov (United States)

Strobel, Werner; Schlageter, Manuel; Andersson, Morgan; Miedinger, David; Chhajed, Prashant N; Tamm, Michael; Leuppi, Jörg D

2011-02-01

Continuous positive airways pressure (CPAP) for treatment of obstructive sleep apnea (OSA) can produce troublesome nasal symptoms (i.e. congestion, rhinorrhea) that may reduce the compliance of CPAP. Topical nasal steroids are often prescribed to reduce these side effects, although scientific data are scarce supporting any benefits of this treatment for CPAP-induced nasal side effects. To study whether a topical nasal steroid can reduce CPAP-induced nasal symptoms and improve CPAP adherence during the initial phase of OSA treatment. A randomized, double-blinded, placebo-controlled study with fluticasone propionate 100 μg/nasal cavity twice daily Treatment was started 10 days prior to and continued throughout the first 4 weeks of CPAP. 63 patients who were selected for CPAP treatment participated. Nasal symptoms were recorded, nasal patency was assessed and lung function was measured with a peak flow meter. The patients' adherence to CPAP was recorded by the CPAP device. Total nasal symptoms increased from baseline to 4 wks after CPAP use for both nasal treatments (p < 0.05). No differences in total nasal symptoms between treatments were seen (p = 1), and no differences in nasal peak flow values after treatment were seen (p = 0.11). Moreover, there were no differences in CPAP use between the treatments. Fluticasone propionate as a nasal topical steroid does not reduce CPAP-induced unwanted nasal side effects, and has no beneficial effect on CPAP compliance during the first four weeks of treatment in unselected patients with OSAS. Copyright © 2010 Elsevier Ltd. All rights reserved.

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

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

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...

13 CFR 108.700 - Compliance with size standards in part 121 of this chapter as a condition of Assistance.

Science.gov (United States)

2010-01-01

... Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Financing of Small Businesses by NMVC Companies Determining the Eligibility of A Small Business for Nmvc Financing § 108.700... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Compliance with size standards in...

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.

Idaho CERCLA Disposal Facility Complex Compliance Demonstration for DOE Order 435.1

Energy Technology Data Exchange (ETDEWEB)

J. Simonds

2006-09-01

This compliance demonstration document provides an analysis of the Idaho CERCLA Disposal Facility (ICDF) Complex compliance with DOE Order 435.1. The ICDF Complex includes the disposal facility (landfill), evaporation pond, admin facility, weigh scale, decon building, treatment systems, and various staging/storage areas. These facilities were designed and are being constructed to be compliant with DOE Order 435.1, Resource Conservation and Recovery Act Subtitle C, and Toxic Substances Control Act polychlorinated biphenyl design and construction standards. The ICDF Complex is designated as the central Idaho National Laboratory (INL) facilityyy for the receipt, staging/storage, treatment, and disposal of INL Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) waste streams. This compliance demonstration document discusses the conceptual site model for the ICDF Complex area. Within this conceptual site model, the selection of the area for the ICDF Complex is discussed. Also, the subsurface stratigraphy in the ICDF Complex area is discussed along with the existing contamination beneath the ICDF Complex area. The designs for the various ICDF Complex facilities are also included in this compliance demonstration document. These design discussions are a summary of the design as presented in the Remedial Design/Construction Work Plans for the ICDF landfill and evaporation pond and the Staging, Storage, Sizing, and Treatment Facility. Each of the major facilities or systems is described including the design criteria.

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).

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...

[Influence of WeChat platform on the compliance of continuous treatment of scar in adult burn patients].

Science.gov (United States)

Wang, F; Zhang, H L

2018-03-20

Objective: To explore influence of the WeChat platform on the compliance of continuous treatment of scar in adult burn patients. Methods: A total of 124 adult burn patients, conforming to the study criteria, admitted in the Department of Burns of our hospital from January 2015 to January 2016 were divided into WeChat group ( n =63) and control group ( n =61) according to the random number table. Patients in control group only received regular discharging rehabilitation guide, while patients in WeChat group received regular discharging rehabilitation guide and joined WeChat platform after being discharged from hospital. Through pushing rehabilitation plan and rehabilitation related knowledge, organizing support discussion of burn patients, answering the patients' questions, members of WeChat platform intervention group conducted continuous treatment for 6 months on patients of WeChat group. The compliance of functional exercise of patients in two groups in one week before discharge and 3 and 6 months after discharge was evaluated by using the self-made functional exercise compliance log sheet. The compliance of using anti-scar drug and appliance of patients in two groups in 3 and 6 months after discharge was evaluated by using self-made anti-scar drug and appliance usage log sheets. Data were processed with chi-square test, independent sample t test, non-parametric rank sum test of independent sample, and Wilcoxon rank sum test. Results: (1) The compliance ratio of functional exercise of patients in WeChat group (95.24%, 60/63) was close to 93.44% (57/61) in control group in one week before discharge ( χ (2)=0.188, P >0.05). The compliance ratios of functional exercise of patients in WeChat group were respectively 93.65% (59/63) and 87.30% (55/63) in 3 and 6 months after discharge, which were higher than 68.85% (42/61) and 65.57% (40/61) in control group ( χ (2)=12.615, 8.166, P WeChat group was significantly better than that in control group in 3 and 6 months

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…

Federal Facilities Compliance Act, Draft Site Treatment Plan: Background Volume, Part 2, Volume 1

International Nuclear Information System (INIS)

1994-01-01

This Draft Site Treatment Plan was prepared by Ames Laboratory to meet the requirements of the Federal Facilities Compliance Act. Topics discussed include: purpose and scope of the plan; site history and mission; draft plant organization; waste minimization; waste characterization; preferred option selection process; technology for treating low-level radioactive wastes and TRU wastes; future generation of mixed waste streams; funding; and process for evaluating disposal issues in support of the site treatment plan

[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.

Notification: EPA’s Compliance with Statement of Federal Financial Accounting Standards No. 47 and Treasury Financial Manual, Part 2, Chapter 4700

Science.gov (United States)

Project #OA&E-FY18-0249, June 6, 2018. The OIG plans to begin preliminary research on the EPA’s compliance with the Statement of Federal Financial Accounting Standards No. 47: Reporting Entity; and Treasury Financial Manual, Part 2, Chapter 4700

Evaluation of the WIPP Project`s compliance with the EPA radiation protection standards for disposal of transuranic waste

Energy Technology Data Exchange (ETDEWEB)

Neill, R.H.; Chaturvedi, L.; Rucker, D.F.; Silva, M.K.; Walker, B.A.; Channell, J.K.; Clemo, T.M. [Environmental Evaluation Group, Albuquerque, NM (United States)]|[Environmental Evaluation Group, Carlsbad, NM (United States)

1998-03-01

The US Environmental Protection Agency`s (EPA) proposed rule to certify that the Waste Isolation Pilot Plant (WIPP) meets compliance with the long-term radiation protection standards for geologic repositories (40CFR191 Subparts B and C), is one of the most significant milestones to date for the WIPP project in particular, and for the nuclear waste issue in general. The Environmental Evaluation Group (EEG) has provided an independent technical oversight for the WIPP project since 1978, and is responsible for many improvements in the location, design, and testing of various aspects of the project, including participation in the development of the EPA standards since the early 1980s. The EEG reviewed the development of documentation for assessing the WIPP`s compliance by the Sandia National Laboratories following the 1985 promulgation by EPA, and provided many written and verbal comments on various aspects of this effort, culminating in the overall review of the 1992 performance assessment. For the US Department of Energy`s (DOE) compliance certification application (CCA), the EEG provided detailed comments on the draft CCA in March, 1996, and additional comments through unpublished letters in 1997 (included as Appendices 8.1 and 8.2 in this report). Since the October 30, 1997, publication of the EPA`s proposed rule to certify WIPP, the EEG gave presentations on important issues to the EPA on December 10, 1997, and sent a December 31, 1997 letter with attachments to clarify those issues (Appendix 8.3). The EEG has raised a number of questions that may have an impact on compliance. In spite of the best efforts by the EEG, the EPA reaction to reviews and suggestions has been slow and apparently driven by legal considerations. This report discusses in detail the questions that have been raised about containment requirements. Also discussed are assurance requirements, groundwater protection, individual protection, and an evaluation of EPA`s responses to EEG`s comments.

Determinants of compliance with nasal continuous positive airway pressure treatment applied in a community setting.

Science.gov (United States)

Ball, E M.; Banks, M B.

2001-05-01

Objectives: To assess determinants of nasal continuous positive airway pressure (CPAP) compliance when applied in a community setting.Background: One-third of obstructive sleep apnea patients eventually refuse CPAP therapy. Treatment outcomes may be improved by identifying predictors of CPAP failure, including whether management by primary care physicians without sleep consultation affects results.Methods: Polysomnogram, chart review, and questionnaire results for regular CPAP users (n=123) were compared with those returning the CPAP machine (n=26).Results: Polysomnographic data and the presence of multiple sleep disorders were only modestly predictive of CPAP compliance. Striking differences in questionnaire responses separated CPAP users from non-users, who reported less satisfaction with all phases of their diagnosis and management. Rates of CPAP use were not significantly different between patients managed solely by their primary care physician or by a sleep consultant.Conclusions: Polysomnographic findings are unlikely to identify eventual CPAP non-compliers in a cost-effective fashion. Improvements in sleep apnea management may result from addressing the role of personality factors and multiple sleep disorders in determining compliance. In this practice setting, management by primary care physicians did not significantly degrade CPAP compliance.

A study at Manchester Dental Hospital, of the compliance of IV sedation patients and their escorts.

Science.gov (United States)

Lightfoot, Kate

2014-01-01

Oral surgery, under intravenous sedation, is carried out on a daily basis at Manchester Dental Hospital. This essay discusses the background of conscious sedation in the dental setting and looks at the compliance of patients (and escorts) when having intravenous sedation. The patient journey, from pre-operative assessment through to treatment is considered. Hospital instructions indicate an obligation for patients to attend with a responsible adult (eighteen or over) who remains with them throughout their treatment, escorts them home,and arranges their care for the next twenty-four hours. By following these instructions the patient should receive optimal care. Two questionnaires were devised and given to patients/escorts to assess their compliance with Manchester Dental Hospital postoperative protocols. 100% compliance was the set standard, with results presented as pie charts. This work began during the undergraduate summer vacation of 2012 and continued over a five-month period. Initial results suggested that compliance was generally good but certain improvements could be made. Suggestions for future development are presented. These aim to give clarity to all patients/escorts and their specific roles in the anticipated treatment.

Oral hygiene compliance in orthodontic patients: a randomized controlled study on the effects of a post-treatment communication.

Science.gov (United States)

Cozzani, Mauro; Ragazzini, Giulia; Delucchi, Alessia; Mutinelli, Sabrina; Barreca, Carlo; Rinchuse, Daniel J; Servetto, Roberto; Piras, Vincenzo

2016-12-01

Several studies have recently demonstrated that a post-treatment communication to explain the importance of an oral hygiene can improve the orthodontic patients' compliance over a period of 66 days. The main goal of this study is to evaluate the effects of a structured follow-up communication after orthodontic appliance application on oral hygiene compliance after 30-40 days. Eighty-four orthodontic participants enrolled from patients who were beginning fixed orthodontic treatment at the Orthodontic Department, Gaslini Hospital, Genova, between July and October 2014 were randomly assigned to one of three trial arms. Before the bonding, all patients underwent a session of oral hygiene aimed at obtaining an plaque index of "zero." At the following orthodontic appointment, the plaque index was calculated for each patient in order to assess oral hygiene compliance. The first group served as control and did not receive any post-procedure communication, the second group received a structured text message giving reassurance, and the third group received a structured telephone call. Participants were blinded to group assignment and were not made aware that the text message or the telephone call was part of the study. (The research protocol was approved by the Italian Comitato Etico Regionale della Liguria-sezione 3^ c/o IRCCS-Istituto G. Gaslini 845/2014, and it is not registered in the trial's register.) RESULTS: Thirty patients were randomly assigned to the control group, 28 participants to the text message group, and 26 to the telephone group. Participants who received a post-treatment communication reported higher level of oral hygiene compliance than participants in the control group. The plaque index was 0.3 (interquartile range (Iqr), 0.60) and 0.75 (Iqr, 1.30), respectively, with a significant difference (P = 0.0205). A follow-up procedure after orthodontic treatment may be an effective tool to increase oral hygiene compliance also over a short period.

Oral hygiene compliance in orthodontic patients: a randomized controlled study on the effects of a post-treatment communication

Directory of Open Access Journals (Sweden)

Mauro Cozzani

2016-12-01

Full Text Available Abstract Background Several studies have recently demonstrated that a post-treatment communication to explain the importance of an oral hygiene can improve the orthodontic patients’ compliance over a period of 66 days. The main goal of this study is to evaluate the effects of a structured follow-up communication after orthodontic appliance application on oral hygiene compliance after 30–40 days. Methods Eighty-four orthodontic participants enrolled from patients who were beginning fixed orthodontic treatment at the Orthodontic Department, Gaslini Hospital, Genova, between July and October 2014 were randomly assigned to one of three trial arms. Before the bonding, all patients underwent a session of oral hygiene aimed at obtaining an plaque index of “zero.” At the following orthodontic appointment, the plaque index was calculated for each patient in order to assess oral hygiene compliance. The first group served as control and did not receive any post-procedure communication, the second group received a structured text message giving reassurance, and the third group received a structured telephone call. Participants were blinded to group assignment and were not made aware that the text message or the telephone call was part of the study. (The research protocol was approved by the Italian Comitato Etico Regionale della Liguria-sezione 3^ c/o IRCCS-Istituto G. Gaslini 845/2014, and it is not registered in the trial’s register. Results Thirty patients were randomly assigned to the control group, 28 participants to the text message group, and 26 to the telephone group. Participants who received a post-treatment communication reported higher level of oral hygiene compliance than participants in the control group. The plaque index was 0.3 (interquartile range (Iqr, 0.60 and 0.75 (Iqr, 1.30, respectively, with a significant difference (P = 0.0205. Conclusions A follow-up procedure after orthodontic treatment may be an effective tool to

Is the standard compliance check protocol a valid measure of the accessibility of tobacco to underage smokers?

Science.gov (United States)

DiFranza, J.; Savageau, J.; Bouchard, J.

2001-01-01

OBJECTIVE—To determine if the standard compliance check protocol is a valid measure of the experience of underage smokers when purchasing tobacco in unfamiliar communities.
SETTING—160 tobacco outlets in eight Massachusetts communities where underage tobacco sales laws are vigorously enforced.
PROCEDURE—Completed purchase rates were compared between underage smokers who behaved normally and inexperienced non-smoking youths who were not allowed to lie or present proof of age (ID).
RESULTS—The "smoker protocol" increased the likelihood of a sale nearly sixfold over that for the non-smokers (odds ratio (OR) 5.7, 95% confidence interval (CI) 1.5 to 22). When the youths presented an ID with an underage birth date, the odds of a completed sale increased dramatically (OR 27, 95% CI 3.4 to 212). Clerks judged to be under 21 years of age were seven times more likely to make an illegal sale (OR 7.6, 95% CI 2.4 to 24.0).
CONCLUSIONS—Commonly used compliance check protocols are too artificial to reflect accurately the experience of underage smokers. The validity of compliance checks might be improved by having youths present ID, and by employing either tobacco users, or non-tobacco users who are sufficiently experienced to mimic the self confidence exhibited by tobacco users in this situation. Consideration should be given to prohibiting the sale of tobacco by individuals under 21 years of age.


Keywords: compliance check protocol; underage smokers PMID:11544386

Analysis of Payment Card Industry Data Security Standard [PCI DSS] Compliance by Confluence of COBIT 5 Framework

OpenAIRE

Ashish Ukidve; Ds S SMantha; Milind Tadvalkar

2017-01-01

The Payment Card Industry Data Security Standard (PCI DSS) aims to enhance the security of cardholder data and is required when cardholder data or authentication data are stored, processed or transmitted. The implementation of enabling processes from COBIT 5 can complement compliance to PCI DSS. COBIT 5 assists enterprises in governance and management of enterprise IT and, at the same time, supports the need to meet security requirements with supporting processes and management activities. Th...

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...

Effectiveness of external inspection of compliance with standards in improving healthcare organisation behaviour, healthcare professional behaviour or patient outcomes

Science.gov (United States)

Flodgren, Gerd; Pomey, Marie-Pascale; Taber, Sarah A; Eccles, Martin P

2014-01-01

Background Inspection systems are used in health care to promote quality improvements, i.e. to achieve changes in organisational structures or processes, healthcare provider behaviour and patient outcomes. These systems are based on the assumption that externally promoted adherence to evidence-based standards (through inspection/assessment) will result in higher quality of health care. However, the benefits of external inspection in terms of organisational, provider and patient level outcomes are not clear. Objectives To evaluate the effectiveness of external inspection of compliance with standards in improving healthcare organisation behaviour, healthcare professional behaviour and patient outcomes. Search methods We searched the following electronic databases for studies: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effectiveness, Scopus, HMIC, Index to Theses and Intute from their inception dates up to May 2011. There was no language restriction and studies were included regardless of publication status. We searched the reference lists of included studies and contacted authors of relevant papers, accreditation bodies and the International Organization for Standardisation (ISO), regarding any further published or unpublished work. Selection criteria We included randomised controlled trials (RCTs), controlled clinical trials (CCTs), interrupted time-series (ITSs) and controlled before and after studies (CBAs) evaluating the effect of external inspection against external standards on healthcare organisation change, healthcare professional behaviour or patient outcomes in hospitals, primary healthcare organisations and other community-based healthcare organisations. Data collection and analysis Two review authors independently applied eligibility criteria, extracted data and assessed the risk of bias of each included study. Since meta-analysis was

Idaho CERCLA Disposal Facility Complex Compliance Demonstration for DOE Order 435.1

Energy Technology Data Exchange (ETDEWEB)

Simonds, J.

2007-11-06

This compliance demonstration document provides an analysis of the Idaho CERCLA Disposal Facility (ICDF) Complex compliance with DOE Order 435.1. The ICDF Complex includes the disposal facility (landfill), evaporation pond, administration facility, weigh scale, and various staging/storage areas. These facilities were designed and constructed to be compliant with DOE Order 435.1, Resource Conservation and Recovery act Subtitle C, and Toxic Substances Control Act polychlorinated biphenyl design and construction standards. The ICDF Complex is designated as the Idaho National Laboratory (INL) facility for the receipt, staging/storage, treatment, and disposal of INL Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) waste streams.

COMPLIANCE TO LONG-TERM TREATMENT OF CARDIOLOGIC PATIENTS WITH MILD TO MODERATE DEPRESSION: INEFFECTIVENESS OF ANTIDEPRESSIVE THERAPY WITH PIRLINDOL IN RANDOMIZED STUDY

Directory of Open Access Journals (Sweden)

E. V. Strokova

2015-12-01

Full Text Available Aim. To evaluate the influence of antidepressant therapy with pirlindol on compliance to the long-term treatment and quality of life in patients with cardiovascular diseases and mild to moderate depression. Material and methods. 61 patients with cardiovascular diseases and mild to moderate depression (according to Beck depression scale were randomized into two groups. Patients of intervention group received pirlindol, while patients of control group did not receive this drug. Compliance to cardiovascular and antidepressant treatment were estimated in 3 and 6 months. Adverse reactions and patients self-assessment of their well-being and global satisfaction in treatmen were also registered.  Results. 24 (75%, 2 (6% and 0 patients of intervention group continue pirlindol treatment in 1, 3 and 6 months, respectively. In 3 months of observation patients of intervention group took drugs for cardiovascular diseases more often than these in control group (81% vs 72%, respectively , р<0.05, they also less frequently showed adverse reactions (56% vs 72%, respectively ,p=0.01 and more often — improvement of their well-being (65% vs 50%, respectively , р=0.03. Compliance to cardiovascular therapy did not differ significantly in patients of both groups by the end the study.  Conclusion. Antidepressant therapy with pirlindol did not influence compliance to long-term cardiovascular treatment in patients with cardiovascular diseases and mild to moderate depression, apparently because of low compliance to pirlindol therapy.

Non-Metropolitan Drinking Water Suppliers’ Response to the Diagnostic Tool for Non-Technical Compliance in Limpopo, South Africa

Directory of Open Access Journals (Sweden)

Avhashoni Dorcas Nefale

2017-11-01

Full Text Available Without the planning of non-technical issues, water treatment plants may face challenges in sustaining safe drinking water. Parameters such as the planning of financial resources, human resources, a lack of professional process controllers, poor working conditions, staff shortages and a lack of appropriate training of process controllers contribute to the underperformance of drinking water treatment plants. This study aimed at applying the Diagnostic Tool for Non-Technical Compliance to assess the compliance of small drinking water plants with management norms. Six water treatments (Vondo water scheme, Malamulele, Mutshedzi, Mutale regional water treatment plant, Tshedza and Tshedza package plant were selected from the Vhembe district municipality of the Limpopo province in South Africa. From the abovementioned non-technical parameters, the results showed that during the first assessment period (August 2008 and June 2009 selected water treatment plants scored between 53% and 68% and fell under Class 2, indicating serious challenges requiring attention and improvement. During the second assessment period (November and December 2010, a slight improvement was observed as all plants scored between 72% and 80%, falling under the Class 2 category. Even after corrective actions and remeasurement, none of the plants met the compliance standards, which range from 90% to 100% to obtain the Class 1 compliance standard. The study recommended that tactical and strategic plans that clearly define the operational procedures, process controlling, financial planning, maintenance culture, emergency preparedness and regular monitoring and evaluation should be entrenched for the smooth running of the small water treatment plants. Furthermore, all water services providers and water services authorities should apply the diagnostic tools as developed, which provides guidance on a stepwise procedure on plant operations and management on a daily basis.

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....

Standards, documents of relevance and directives in individual monitoring: is European individual monitoring in compliance with standards?

International Nuclear Information System (INIS)

Fantuzzi, E.

2005-01-01

Full text: Individual monitoring services in Europe do not comply with the same legal or approval requirements. Anyway, a degree of harmonization existing in individual monitoring practices in Europe has been achieved mainly thank to documents as standards or international recommendations, which with a different weight, represent invaluable vehicles of condensed information transfer. However, implementation of standards is not straightforward and harmonization is not directly a consequence. Somehow, 'harmony' is needed also in standards: IEC and ISO standards on performance requirements for dosemeters sometimes have different approaches (i.e. performance criteria). If used for approval, passing one will not necessarily mean passing all. Moreover, standards do not all refer to reliability, and therefore being in compliance with standards does not itself assure that dose results are reliable. This might apply only to ISO/IEC17025 'quality' standard, which represents the best available tool for the quality of laboratory work and somehow include all technical and management requirements. When accredited according to ISO/IEC17025, an Individual Monitoring Service (IMS) fulfils standards. Standards are not the only reference documents for an IMS. EURADOS working group on 'Harmonization of Individual Monitoring in Europe', who has been active in the years 2001-2004, suggested a classification of publication on individual monitoring, distinguishing between standards and documents of relevance, which can be both national and international. A standard, unlike a textbook or technical publication, does not cover the experience and opinion of one or few individuals only, but the consensus of the entire scientific and technical community concerned. Most of the standards applicable to individual monitoring are published by IEC or ISO, or both together. However, it has to be kept in mind that ISO and IEC standards, for example, are meant for manufactures and industry, which do not

The importance of clinical monitoring for compliance with Continuous Positive Airway Pressure.

Science.gov (United States)

Pelosi, Lucas B; Silveira, Mariana L C; Eckeli, Alan L; Chayamiti, Emilia M P C; Almeida, Leila A; Sander, Heidi H; Küpper, Daniel S; Valera, Fabiana C P

Obstructive sleep apnea syndrome is currently a public health problem of great importance. When misdiagnosed or improperly treated, it can lead to serious consequences on patients' quality of life. The gold standard treatment for cases of obstructive sleep apnea syndrome, especially in mild to severe and symptomatic cases, is continuous positive airway pressure therapy. Compliance with continuous positive airway pressure therapy is directly dependent on the active participation of the patient, which can be influenced by several factors. The objective of this study is to describe the factors related to compliance with continuous positive airway pressure therapy, and to analyze which associated factors directly influence the efficiency of the treatment. Patients who received continuous positive airway pressure therapy through the Municipal Health Department of the city of Ribeirão Preto were recruited. A structured questionnaire was administered to the patients. Compliance with continuous positive airway pressure therapy was assessed by average hours of continuous positive airway pressure therapy usage per night. Patients with good compliance (patients using continuous positive airway pressure therapy ≥4h/night) were compared to those with poor compliance (patients using <4h/night). 138 patients were analyzed: 77 (55.8%) were considered compliant while 61 (44.2%) were non-compliant. The comparison between the two groups showed that regular monitoring by a specialist considerably improved compliance with continuous positive airway pressure therapy (odds ratio, OR=2.62). Compliance with continuous positive airway pressure therapy is related to educational components, which can be enhanced with continuous and individualized care to patients with obstructive sleep apnea syndrome. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Environmental effectiveness of GAEC cross-compliance Standard 3.1 ‘Ploughing in good soil moisture conditions’ and economic evaluation of the competitiveness gap for farmers

Directory of Open Access Journals (Sweden)

Rosa Francaviglia

2015-11-01

Full Text Available Within the MO.NA.CO. Project the environmental effectiveness of GAEC cross-compliance Standard 3.1 ‘Ploughing in good soil moisture conditions’ was evaluated, as well as the economic evaluation of the competitiveness gap for farmers which conform or do not conform to cross-compliance. The monitoring has been carried out at nine experimental farms with different pedoclimatic characteristics, where some indicators of soil structure degradation have been evaluated, such as bulk density, packing density and surface roughness of the seedbed, and the crop productive and qualitative parameters. In each monitoring farm two experimental plots have been set up: factual with soil tillage at proper water content (tilth, counterfactual with soil tillage at inadequate water content (no tilth. The monitoring did not exhibit univocal results for the different parameters, thus the effectiveness of the Standard 3.1 is ‘contrasting’ (class of merit B, and there was an evident practical problem to till the soil at optimum water content, even in controlled experimental condition. Bulk density was significantly lower in the factual treatment although in soils with very different textures (sandy-loam and clayey. Packing density (PD showed a high susceptibility to compaction in soils with low PD and medium texture. The tortuosity index, indicating the roughness of the seedbed, was lower and generally significantly different in the factual treatment. Results showed that the ploughing done in excessive soil moisture conditions is more expensive due to the increased force of traction of the tractor, which causes an increase in slip of the tractor wheels, with a speed reduction and increase in the working times and fuel consumption. Moreover, the crop yield is also reduced considerably according to the cultivated species.

Effect of intervention using a messaging app on compliance and duration of treatment in orthodontic patients.

Science.gov (United States)

Li, Xue; Xu, Zhen-Rui; Tang, Na; Ye, Cui; Zhu, Xiao-Ling; Zhou, Ting; Zhao, Zhi-He

2016-11-01

This study aims to determine the effectiveness of a messaging app (WeChat) in improving patients' compliance and reducing the duration of orthodontic treatment (DOT). A randomized controlled trial was performed in a dental hospital and a clinic from August 2012 to May 2015. Orthodontic patients were included at the beginning of treatment. Patients with multiphase treatment or braceless technique were excluded. Participants were randomized to WeChat group (received regular reminders and educational messages) or control group (received conventional management) and were followed up until the treatment was completed. Primary outcome measure was DOT. Others were late and failed attendance, bracket bond failure, and oral hygiene condition. One hundred twelve patients in each group participated and completed the trial. DOT in WeChat group were 7.3 weeks shorter (P = 0.007). There were less failed attendance (3.1 vs. 10.9 %, P bond failure (11.8 vs. 16.1 %, P duration and bracket bond failure, and improving the attendance in orthodontic patients. DOT can be reduced by improving patient's compliance. The messaging app is useful for outpatient education and management.

[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

Implementation of an Educational Cartoon ("the Patchbook") and Other Compliance-Enhancing Measures by Orthoptists in Occlusion Treatment of Amblyopia.

Science.gov (United States)

Tjiam, A M; Asjes-Tydeman, W L; Holtslag, G; Vukovic, E; Sinoo, M M; Loudon, S E; Passchier, J; de Koning, H J; Simonsz, H J

2016-09-01

This implementation study evaluated orthoptists' use of an educational cartoon ("the Patchbook") and other measures to improve compliance with occlusion therapy for amblyopia. Participating orthoptists provided standard orthoptic care for one year, adding the Patchbook in the second year. They attended courses on compliance and intercultural communication by communication skills training. Many other compliance-enhancing measures were initiated. Orthoptists' awareness, attitude, and activities regarding noncompliance were assessed through interviews, questionnaires, and observations. Their use of the Patchbook was measured. The study was performed in low socio-economic status (SES) areas and in other areas in the Netherlands. It was attempted to integrate education on compliance into basic and continuing orthoptic training. The Patchbook was used by all 9 orthoptists who participated in low-SES areas and 17 of 23 orthoptists in other areas. Courses changed awareness and attitude about compliance, but this was not sustained. Although orthoptists estimated compliance during patching at 70%, three-quarters never suspected noncompliance during a full day of observation in any of their patients. Explanations to parents who spoke Dutch poorly were short. In the second year, explanations to children were longer. Implementation of all 7 additional compliance-enhancing measures failed. Education on compliance was not integrated into orthoptists' training. Almost all orthoptists used the Patchbook and, as another study demonstrated, it proved to be very effective, especially in low-SES areas. Duration of explanation was inversely proportional to parents' fluency in Dutch. Noncompliance was rarely suspected by orthoptists. Although 7 additional compliance-enhancing measures had been conceived and planned with the best intentions, they were not realized. These required extra, unpaid time from the orthoptists, which is especially scarce in hospitals in low-SES areas where the

Standard Compliance: Guidelines to Help State and Alternative Fuel Provider Fleets Meet Their Energy Policy Act Requirements, 10 CFR Part 490 (Book)

Energy Technology Data Exchange (ETDEWEB)

2014-03-01

This guidebook addresses the primary requirements of the Alternative Fuel Transportation Program to help state and alternative fuel provider fleets comply with the Energy Policy Act via the Standard Compliance option. It also addresses the topics that covered fleets ask about most frequently.

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)

Evaluation of the relationship between compliance with the follow-up and treatment protocol and health literacy in bladder tumor patients.

Science.gov (United States)

Turkoglu, Ali Riza; Demirci, Hakan; Coban, Soner; Guzelsoy, Muhammet; Toprak, Erdem; Aydos, Mustafa Murat; Ture, Deniz Azkan; Ustundag, Yasemin

2018-03-07

To investigate the relationship between the compliance of bladder cancer patients with cystoscopic follow-up and the treatment protocol, and their health literacy. Patients who underwent transurethral resection surgery for bladder tumor were found to have non-muscular invasive bladder carcinoma on pathology examination and then underwent cystoscopic follow-up for 1 year or more were included in the study. Cystoscopic follow-up was recommended to the low- and high-risk groups in terms of progression and recurrence. The patients were evaluated with the Health Literacy Survey-European Union scale. The mean age of the patients was 67.13 ± 10.77 years. The treatment continuity rate was 80.50% (n = 33) in the adequate health literacy group (n = 41) and significantly higher than the 56.50% (n = 48) rate in the inadequate health literacy group (n = 85) (p = .008). The health literacy results revealed that the health promotion and general index score was higher in the group of patients under the age of 65. Adequate health literacy in bladder cancer patients is associated with better compliance with the treatment protocol. Young patients show better compliance with the follow-up protocol recommended by the physician. Increasing the follow-up protocol compliance of elderly patients with inadequate health literacy is necessary.

Cultural Adaptation and Reliability of the Compliance with Standard Precautions Scale (CSPS) for Nurses in Brazil.

Science.gov (United States)

Pereira, Fernanda Maria Vieira; Lam, Simon Ching; Gir, Elucir

2017-03-02

this study aimed to carry of the cultural adaptation and to evaluate the reliability of the Compliance with Standard Precautions Scale (CSPS) for nurses in Brazil. the adaptation process entailed translation, consensus among judges, back-translation, semantic validation and pretest. The reliability was evaluated by internal consistency (Cronbach alpha) and stability (test-retest). The instrument was administered to a sample group of 300 nurses who worked in a large hospital located in the city of São Paulo/SP, Brazil. through the semantic validation, the items from the scale were considered understandable and deemed important for the nurse´s clinical practice. The CSPS Brazilian Portuguese version (CSPS-PB) revealed excellent interpretability. The Cronbach`s alpha was 0.61 and the intraclass correlation coefficient was 0.85. the initial study showed that CSPS-PB is appropriate to assess compliance with standard precautions among nurses in Brazil. The reliability was considered acceptable. Furhter study is necessary to evaluate its comprehensive psychometric properties. adaptar culturalmente y evaluar la confiabilidad de la Compliance with Standard Precautions Scale (CSPS) para enfermeros en Brasil. el proceso de adaptación abarcó la traducción, consenso entre jueces, retrotraducción, validación semántica y pretest. La confiabilidad fue evaluada mediante la consistencia interna (alfa de Cronbach) y estabilidad (test-retest). El instrumento fue administrado a una muestra de 300 enfermeros actuantes en un gran hospital ubicado en la ciudad de São Paulo/SP, Brasil. a través de la validación semántica, los ítems de la escala fueron considerados comprensibles e importantes para la práctica clínica enfermera. La versión en portugués de Brasil de la CSPS (CSPS-PB) reveló excelente posibilidad de interpretación. El alfa de Cronbach correspondió a 0.61 y el coeficiente de correlación intraclase fue 0.85. el estudio inicial mostró que la CSPS-PB es

QUALITY OF LIFE AND COMPLIANCE TO THERAPY IN PATIENTS FOLLOWING SUCCESSFULTRANSLUMINAL CORONARY ANGIOPLASTY, WHO WERE PRESCRIBED FLUVASTATIN EXTENDED RELEASE ADDED TO STANDARD THERAPY. PROTOCOL OF THE OPEN-LABEL OBSERVATIONAL STUDY

Directory of Open Access Journals (Sweden)

A. V. Susekov

2010-01-01

Full Text Available Aim. To evaluate quality of life changes and compliance to therapy in patients following successful transluminal angioplasty, who have indications for fluvastatin extended release in addition to standard treatment.Material and methods. This is a national observational multicenter study. An inclusion of 60 investigator centers is planned (out-patient medical centers, the total number of patients to be included is 600. Patients (men and women with coronary heart disease following successful transluminal coronary angioplasty, who were prescribed fluvastatinextended release (Lescol Forte, Novartis 80 mg once daily will be included in the observation. The following efficacy and safety parameters will be evaluated: quality of life assessed with SF-36 scale before and during treatment; compliance to therapy; adverse events and serious adverse events. Observation period is planned for 6 months. During this period patient is expected to make 4 visits to treating physician. According to the physician’s decision, observation period can be extended to 12 months.Present study status. The study is completed. 524 patients completed the observation, including 116 patients who were followed up for 12 months. There are 414 men (79% and 110 women (21% among patients enrolled into the study.

40 CFR 60.24 - Emission standards and compliance schedules.

Science.gov (United States)

2010-07-01

... energy input from all fuel except biomass if the unit is a boiler. Combustion turbine means: (1) An... been demonstrated, States may balance the emission guidelines, compliance times, and other information... energy input” in § 60.4102 of this chapter promulgated on October 19, 2007, provided that the State...

Federal facilities compliance act waste management

International Nuclear Information System (INIS)

Bowers, J.; Gates-Anderson, D.; Hollister, R.; Painter, S.

1999-01-01

Site Treatment Plans (STPs) developed through the Federal Facilities Compliance Act pose many technical and administrative challenges. Legacy wastes managed under these plans require Land Disposal Restriction (LDR) compliance through treatment and ultimate disposal. Although capacity has been defined for most of the Department of Energy wastes, many waste streams require further characterization and many need additional treatment and handling beyond LDR criteria to be able to dispose of the waste. At Lawrence Livermore National Laboratory (LLNL), the Hazardous Waste Management Division has developed a comprehensive Legacy Waste Program. The program directs work to manage low level and mixed wastes to ensure compliance with nuclear facility rules and its STP. This paper provides a survey of work conducted on these wastes at LLNL. They include commercial waste treatment and disposal, diverse forms of characterization, inventory maintenance and reporting, on-site treatment, and treatability studies. These activities are conducted in an integrated fashion to meet schedules defined in the STP. The processes managing wastes are dynamic due to required integration of administrative, regulatory, and technical concerns spanning the gamut to insure safe proper disposal

Personalized versus standardized dosing strategies for the treatment of childhood amblyopia: study protocol for a randomized controlled trial.

Science.gov (United States)

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

2015-04-25

Amblyopia is the commonest visual disorder of childhood in Western societies, affecting, predominantly, spatial visual function. Treatment typically requires a period of refractive correction ('optical treatment') followed by occlusion: covering the nonamblyopic eye with a fabric patch for varying daily durations. Recent studies have provided insight into the optimal amount of patching ('dose'), leading to the adoption of standardized dosing strategies, which, though an advance on previous ad-hoc regimens, take little account of individual patient characteristics. This trial compares the effectiveness of a standardized dosing strategy (that is, a fixed daily occlusion dose based on disease severity) with a personalized dosing strategy (derived from known treatment dose-response functions), in which an initially prescribed occlusion dose is modulated, in a systematic manner, dependent on treatment compliance. A total of 120 children aged between 3 and 8 years of age diagnosed with amblyopia in association with either anisometropia or strabismus, or both, will be randomized to receive either a standardized or a personalized occlusion dose regimen. To avoid confounding by the known benefits of refractive correction, participants will not be randomized until they have completed an optical treatment phase. The primary study objective is to determine whether, at trial endpoint, participants receiving a personalized dosing strategy require fewer hours of occlusion than those in receipt of a standardized dosing strategy. Secondary objectives are to quantify the relationship between observed changes in visual acuity (logMAR, logarithm of the Minimum Angle of Resolution) with age, amblyopia type, and severity of amblyopic visual acuity deficit. This is the first randomized controlled trial of occlusion therapy for amblyopia to compare a treatment arm representative of current best practice with an arm representative of an entirely novel treatment regimen based on statistical

Needs assessment and treatment compliance at state opioid substitution treatment programes in Georgia.

Science.gov (United States)

Piralishvili, G; Gamkrelidze, I; Nikolaishvili, N; Chavchanidze, M

2013-01-01

conduct needs assessments and treatment compliance evaluations in MMT and Suboxone Substitution State Programs in Georgia (Republic of). 506 patients (2 females) were surveyed (92% on Methadone, 8% on Suboxone) from 6 Tbilisi and 4 regional State Programs in 2011 November. Mean age - 40±8,56 (22-65) year; 254 (51.4%) were in treatment for 1-3 year. Evaluation was carried out on the base of structured self-questionnaire that covers demographics, drug use history, general drug use trends, psychotherapeutic sessions' acceptance and open label question regarding treatment challenges and satisfaction. 305 (60.3%) attended individual and 57 (11.3%) group psychotherapy sessions with 50.79% attending once/month or rare. The main reason given for therapy non-attendance - no needs for it (29.48%); the main drugs before admission - heroin (80.04%), buprenorphine (53.49%); Main drugs used in Georgia nowadays - desomorphine ("crocodile"), alcohol and marihuana. Commonly used drugs by program patients (136 positive answers) - alcohol-13.62%, marihuana-10.39%, pregabalin - 8.17%, opioids- 6.62% (mostly-"crocodile"), home-made stimulants-6.23%, sedatives -5.45%. 55.4% are extremely satisfied with treatment, 82.4% - with program staff. Patients' main wishes- free of charge programs (46.4%) and provide take-home doses (22.07%). Methadone and Suboxone ST are being well accepted in Georgia and appear to be reducing illegal opioid use. However, the psychotherapeutic sessions' attendance is very low.

Ship Compliance in Emission Control Areas: Technology Costs and Policy Instruments.

Science.gov (United States)

Carr, Edward W; Corbett, James J

2015-08-18

This paper explores whether a Panama Canal Authority pollution tax could be an effective economic instrument to achieve Emission Control Area (ECA)-like reductions in emissions from ships transiting the Panama Canal. This tariff-based policy action, whereby vessels in compliance with International Maritime Organisation (IMO) ECA standards pay a lower transit tariff than noncompliant vessels, could be a feasible alternative to petitioning for a Panamanian ECA through the IMO. A $4.06/container fuel tax could incentivize ECA-compliant emissions reductions for nearly two-thirds of Panama Canal container vessels, mainly through fuel switching; if the vessel(s) also operate in IMO-defined ECAs, exhaust-gas treatment technologies may be cost-effective. The RATES model presented here compares current abatement technologies based on hours of operation within an ECA, computing costs for a container vessel to comply with ECA standards in addition to computing the Canal tax that would reduce emissions in Panama. Retrofitted open-loop scrubbers are cost-effective only for vessels operating within an ECA for more than 4500 h annually. Fuel switching is the least-cost option to industry for vessels that operate mostly outside of ECA regions, whereas vessels operating entirely within an ECA region could reduce compliance cost with exhaust-gas treatment technology (scrubbers).

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.

Tool for evaluation compliance standards and expectations in occupational risk prevention by collaborating companies; Herramienta para evaluacion cumplimiento normas y expectativas en prevencion de riesgos laborales por pare de empresas colaboradoras

Energy Technology Data Exchange (ETDEWEB)

Duran Perez, A.; Gomez Pardo, M. A.; Cao Tejero, R.; Millan Verdejo, J. A.; Blas Perez, P.

2013-07-01

Within the framework of a single security in ANAV, in our Action Plan on prevention, we consider it essential to include workers from ECCE working for and by ANAV in compliance with standards and expectations both in the accounts of the incidents. With this system is intended to standardize a set of observed deviations report and a tool for measuring the degree of compliance, allowing to monitor the evolution of each company and the effectiveness of prevention plan.

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

Compliance to Standard Equipment Requirements by Exercise Therapy/Fitness Outfits in The South-South Geopolitical Zone of Nigeria

Directory of Open Access Journals (Sweden)

Oluwaseun S. Kubeyinje

2016-08-01

Full Text Available The purpose of this study was to assess the compliance of exercise therapy/fitness outfits in the south-south geopolitical zone of Nigeria to standard equipment requirements. Descriptive survey design was adopted for the conduct of the study using a sample size of 51centres/managers purposively selected from a population of 102 managers of fitness outfits in the six states of the south-south geopolitical zone of Nigeria. A self- developed structured questionnaire and a facility checklist were used to collect the data. Data collected were analysed using frequency counts and percentages. The study revealed in this analysis that only treadmills (66.7%, bicycle ergometers (66.7%, dumbbells (84.3% and weight racks (57.0% met the benchmark minimum in more than 50% of the exercise therapy/fitness outfits surveyed in six states of the south-south geopolitical zone of Nigeria. Most of the equipment surveyed were functional with the highest non-functionality occurring in treadmill machines in 9.8% of the surveyed centres followed by sit-up benches (5.9% and bicycle ergometers (3.9%. In conclusion, it could be deduced from the results that there’s gross inadequacy of equipment and low level of compliance to established standard in the exercise therapy/fitness outfits evaluated in the south-south geopolitical zone of Nigeria.

40 CFR 160.17 - Effects of non-compliance.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Effects of non-compliance. 160.17... GOOD LABORATORY PRACTICE STANDARDS General Provisions § 160.17 Effects of non-compliance. (a) EPA may refuse to consider reliable for purposes of supporting an application for a research or marketing permit...

Quality beyond compliance.

Science.gov (United States)

Centanni, N; Monroe, M; White, L; Larson, R

1999-01-01

The service sector within the biopharmaceutical industry has experienced phenomenal growth over the past decade. In the highly regulated Good Laboratory Practices environment, the need for timely, high-quality service, accurate results, and on-time deliverables becomes paramount for the success and profitability of biopharmaceutical companies. The quality assurance process is a vital component of this drug product-development cycle and ensures compliance to the highest domestic and international regulatory standards. Quality-assurance professionals historically have held the role of independent auditors of the processes, who certify that results meet current standards of practice. Covance, a contract research organization that includes Good Laboratory Practices laboratories, reorganized and expanded the functional responsibilities of its quality assurance team in 1997. Auditors and quality assurance professionals have assumed roles beyond traditional compliance auditing and are forging new leadership and mentoring roles as process-improvement specialists. The results have been tangible, measurable benefits for clients and the Covance organization. This article provides an overview of this cultural change and the processes put in place to improve efficiency, productivity, and customer and employee satisfaction.

Streamlining Compliance Validation Through Automation Processes

Science.gov (United States)

2014-03-01

INTENTIONALLY LEFT BLANK xv LIST OF ACRONYMS AND ABBREVIATIONS ACAS Assured Compliance Assessment Suite AMP Apache- MySQL -PHP ANSI American...enemy. Of course , a common standard for DoD security personnel to write and share compliance validation content would prevent duplicate work and aid in...process and consume much of the SCAP content available. Finally, it is free and easy to install as part of the Apache/ MySQL /PHP (AMP) [37

PCI DSS a practical guide to implementing and maintaining compliance

CERN Document Server

Wright, Steve

2011-01-01

This newly revised, practical guide, gives you a step by step guide to achieving Payment Card Industry Data Security Standard (PCI DSS) compliance - showing you how to create, design and build a PCI compliance framework.

Treatment of Helicobacter pylori infection 2010.

LENUS (Irish Health Repository)

O'Connor, Anthony

2012-02-01

It is accepted that the success of Helicobacter pylori eradication treatment using standard triple therapy is declining. Resistance, particularly to clarithromycin, has been shown in numerous countries to be rising to a level where the use of standard triple therapy in its current form may no longer be justified. The two major factors influencing resistance are prior exposure to the antibiotic and compliance with therapy. Regimes based on bismuth and levofloxacin, which had previously been mainly second-line options, are now emerging as superior first-line options. Trials of sequential and concomitant therapies are also showing the usefulness of these treatments in different populations. Options for third and subsequent line therapies include furazolidone and rifabutin-based regimes. Susceptibility testing should be performed to maintain accurate data on resistance levels, and has also clinical utility in difficult to eradicate cases. None of these, however, will be successful unless compliance is improved upon. If compliance is assured and eradication confirmation pursued, it has been repeatedly illustrated that near full eradication is achievable.

Compliance to the prescribed dose and overall treatment time in five randomized clinical trials of altered fractionation in radiotherapy for head-and-neck carcinomas

International Nuclear Information System (INIS)

Khalil, Azza A.; Bentzen, Soeren M.; Bernier, Jacques; Saunders, Michele I.; Horiot, Jean-Claude; Bogaert, Walter van den; Cummings, Bernard J.; Dische, Stanley

2003-01-01

Purpose: To investigate compliance to the prescribed dose-fractionation schedule in five randomized controlled trials of altered fractionation in radiotherapy for head-and-neck carcinoma. Methods and Materials: Individual patient data from 2566 patients participating in the European Organization for Research and Treatment of Cancer (EORTC) 22791, EORTC 22811, EORTC 22851, Princess Margaret Hospital (PMH), and continuous hyperfractionated accelerated radiotherapy (CHART) head-and-neck trials were merged in the fractionation IMPACT (Intergroup Merger of Patient data from Altered or Conventional Treatment schedules) study database. The ideal treatment time was defined as the minimum time required to deliver a prescribed schedule. Compliance to the prescribed overall treatment time was quantified as the difference between the actual and the ideal overall time. An overall measure of compliance in an individual patient, the total dose lost (TDL), was calculated as the dose lost due to prolongation of therapy (assuming a D prolif of 0.64 Gy/day) plus the difference between the prescribed and the actual dose given. Results: The time in excess of the ideal ranged up to 97 days (average 3.9 days), and 25% of the patients had delays of 6 days or more. World Health Organization (WHO) performance status and nodal stage had a significant effect on TDL. TDL was significantly higher in the conventional than in the altered arm of the EORTC 22851 and CHART trials. In the PMH trial, TDL was significantly higher in the hyperfractionation than in the conventional arm. Centers participating in the three EORTC trials varied significantly in their compliance. There was a significant improvement in compliance in patients treated more recently. Conclusions: Even in randomized controlled trials, compliance to the prescribed radiation therapy schedule may be relatively poor, especially after conventional fractionation. This affects the interpretation of the outcome of these trials

Environmental surveillance and compliance at Los Alamos during 1996

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-09-01

This report presents environmental data that characterize environmental performance and addresses compliance with environmental standards and requirements at Los Alamos National Laboratory (LANL or the Laboratory) during 1996. The Laboratory routinely monitors for radiation and for radioactive nonradioactive materials at Laboratory sites as well as in the surrounding region. LANL uses the monitoring results to determine compliance with appropriate standards and to identify potentially undesirable trends. Data were collected in 1996 to assess external penetrating radiation; quantities of airborne emissions; and concentrations of chemicals and radionuclides in ambient air, surface waters and groundwaters, the municipal water supply, soils and sediments, and foodstuffs. Using comparisons with standards and regulations, this report concludes that environmental effects from Laboratory operations are small and do not pose a demonstrable threat to the public, Laboratory employees, or the environment. Laboratory operations were in compliance with all major environmental regulations.

Environmental surveillance and compliance at Los Alamos during 1996

International Nuclear Information System (INIS)

1997-09-01

This report presents environmental data that characterize environmental performance and addresses compliance with environmental standards and requirements at Los Alamos National Laboratory (LANL or the Laboratory) during 1996. The Laboratory routinely monitors for radiation and for radioactive nonradioactive materials at Laboratory sites as well as in the surrounding region. LANL uses the monitoring results to determine compliance with appropriate standards and to identify potentially undesirable trends. Data were collected in 1996 to assess external penetrating radiation; quantities of airborne emissions; and concentrations of chemicals and radionuclides in ambient air, surface waters and groundwaters, the municipal water supply, soils and sediments, and foodstuffs. Using comparisons with standards and regulations, this report concludes that environmental effects from Laboratory operations are small and do not pose a demonstrable threat to the public, Laboratory employees, or the environment. Laboratory operations were in compliance with all major environmental regulations

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.

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

Role of disposal in developing Federal Facility Compliance Act mixed waste treatment plans

International Nuclear Information System (INIS)

Case, J.T.; Rhoderick, J.

1994-01-01

The Federal Facilities Compliance Act (FFCA) was enacted on October 6, 1992. This act amends the Solid Waste Disposal Act, which was previously amended by the Resource Conservation and Recovery Act (RCRA). The FFCA set in place a process for managing the Department of Energy's (DOE) mixed low-level radioactive wastes (MLLW), wastes that contain both hazardous and low-level radioactive constituents, with full participation of the affected states. The FFCA provides the framework for the development of treatment capacity for DOE's mixed waste. Disposal of the treatment residues is not addressed by the FFCA. DOE has initiated efforts in concert with the states in the development of a disposal strategy for the treated mixed wastes. This paper outlines DOE efforts in development of a mixed waste disposal strategy which is integrated with the FFCA Site Treatment Planning process

Spanish Compliance With Guidelines for Prescribing Four Drugs in the Intensive Phase of Standard Tuberculosis Treatment.

Science.gov (United States)

García-García, José-María; Rodrigo, Teresa; Casals, Martí; Ruiz-Manzano, Juan; Pascual-Pascual, Teresa; Caylà, Joan A

2016-05-01

International and Spanish guidelines recommend a 4-drug regimen in the intensive treatment of tuberculosis (TB). The aim of our study was to determine if these recommendations are followed in Spain, and the factors associated with the use of 3 drugs (standard regimen without ethambutol). Observational, multicenter, retrospective analysis of data from patients diagnosed with TB in practically all Spanish Autonomous Communities between 2007 and 2102. Factors associated with the use of 3 drugs were analyzed using logistic regression, and odds ratios (OR) and corresponding 95% confidence intervals (CI) were calculated. A total of 3,189 patients were included, 1,413 (44.3%) of whom received 3 drugs. The percentage of 3-drug users among patients with positive sputum smear was 41.2%; among patients with resistance to at least 1 drug, 36.1%; among HIV-infected patients, 31.4%; and among immigrants, 24.8%. Factors associated with the use of 3 drugs were: female sex (OR=1.18; CI: 1.00-1.39); native Spanish (OR=3.09; CI: 2.58-3.70); retired (OR=1.42; CI: 1.14-1.77); homeless (OR=3.10; CI: 1.52-6.43); living alone (OR=1.62; CI: 1.11-2.36); living in a family (OR=1.97; CI: 1.48-2.65); seen by specialists in the region (OR=1.37; CI: 1.10;1.70); no HIV infection (OR=1.63; CI: 1.09-2.48); and negative sputum smear with positive culture (OR=1.59; CI: 1.25-2.02). A large proportion of TB patients receive intensive treatment with 3 drugs. TB treatment recommendations should be followed, both in routine clinical practice and by the National Plan for Prevention and Control of Tuberculosis in Spain. Copyright © 2015 SEPAR. Published by Elsevier Espana. All rights reserved.

Radiation therapy: model standards for determination of need

International Nuclear Information System (INIS)

Lagasse, L.G.; Devins, T.B.

1982-03-01

Contents: Health planning process; Health care requirements (model for projecting need for megavoltage radiation therapy); Operational objectives (manpower, megavoltage therapy and treatment planning equipment, support services, management and evaluation of patient care, organization and administration); Compliance with other standards imposed by law; Financial feasibility and capability; Reasonableness of expenditures and costs; Relative merit; Environmental impact

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.

Critical scientific issues in the demonstration of WIPP compliance with EPA repository standards

International Nuclear Information System (INIS)

Weart, W.D.; Chu, M.S.Y.

1997-01-01

The Department of Energy submitted a Compliance Certification Application for the Waste Isolation Pilot Plant to the Environmental Protection Agency (EPA) in October, 1996. A critical part of this application was a Performance Assessment which predicts the cumulative radioactive release to the accessible environment over a time period of 10,000 years. Comparison of this predicted release to the EPA standard shows a comfortable margin of compliance. The scientific understanding that was critical to developing this assessment spans a broad range of geotechnical disciplines, and required a thorough understanding of the site's geology and hydrology. Evaluation of the geologic processes which are active in the site region establishes that there will be no natural breach of site integrity for millions of years, far longer than the 10,000 year regulatory period. Inadvertent human intrusion is, therefore, the only credible scenario to lead to potential radioactive release to the accessible environment. To substantiate this conclusion and to quantify these potential releases from human intrusion, it has been necessary to develop an understanding of the following processes: (1) salt creep and shaft seal efficacy; (2) gas generation from organic decomposition of waste materials and anoxic corrosion of metals in the waste and waste packages; (3) solubilities for actinides in brine; (4) fluid flow in Salado formation rocks, and (5) hydrologic transport of actinides in the overlying dolomite aquifers. Other issues which had to be evaluated to allow definition of breach scenarios were brine reservoir occurrences and their associated reservoir parameters, consequences of mining over the repository, and drilling for natural resources in the vicinity of the repository. Results of all these studies will be briefly summarized in this paper

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

A guide for determining compliance with the Clean Air Act Standards for radionuclide emissions from NRC-licensed and non-DOE federal facilities (Rev. 1)

Energy Technology Data Exchange (ETDEWEB)

NONE

1989-10-01

The Environmental Protection Agency (EPA) issued standards under Section 112 of the Clean Air Act of February 6, 1985 that limit airborne emissions of radionuclides to the atmosphere. In February 1989 these standards were re proposed , and in November 1989 final standards may be promulgated. This document provides guidance for determining compliance with one of the National Emissions for Hazardous Air Pollutants covering facilities that are licensed by NRC, and federal facilities not operated by the DOE, that could emit radionuclides to the ai00.

European Union bulk tank SCC standards and proposed US standards: Compliance based on data from four Federal Milk Marketing Orders

Science.gov (United States)

The objective of this study was to evaluate compliance of US producers with the proposed BTSCC limits. Four different SCC levels of compliance were evaluated: 750K; 600K; 500K; 400K. For the 12 month period ending October 2010, 1.0% of producers and 0.2% of milk exceeded the current US limit of 750K...

Updated ozone absorption cross section will reduce air quality compliance

Directory of Open Access Journals (Sweden)

E. D. Sofen

2015-12-01

et al. (2015 as 1.8 % smaller than the accepted value (Hearn, 1961 used for the preceding 50 years. Thus, ozone measurements that applied the older cross section systematically underestimate the amount of ozone in air. We correct the reported historical surface data from North America and Europe and find that this modest change in cross section has a significant impact on the number of locations that are out of compliance with air quality regulations if the air quality standards remain the same. We find 18, 23, and 20 % increases in the number of sites that are out of compliance with current US, Canadian, and European ozone air quality health standards for the year 2012. Should the new cross-section value be applied, it would impact attainment of air quality standards and compliance with relevant clean air acts, unless the air quality target values themselves were also changed proportionately. We draw attention to how a small change in gas metrology has a global impact on attainment and compliance with legal air quality standards. We suggest that further laboratory work to evaluate the new cross section is needed and suggest three possible technical and policy responses should the new cross section be adopted.

Compliance Function in Banks, Investment and Insurance Companies after MiFID

OpenAIRE

Musile Tanzi, Paola; Gabbi, Giampaolo; Previati, Daniele; Schwizer, Paola

2010-01-01

The risk of compliance comes from the failure to comply with laws, regulations, rules, self-regulatory standards, and codes of conduct. This article focuses on the evolving scenario of the compliance function within banks, investment and insurance companies operating in Italy. We developed four areas of research questions: (i) Does the positioning of the compliance function in the organizational structure start “at the top”? (ii) Are roles attributed to the compliance ...

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)

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.

Challenges and perspectives of compliance with pediatric antiretroviral therapy in Sub-Saharan Africa.

Science.gov (United States)

Dahourou, D L; Leroy, V

2017-12-01

More than 3 million children aged less than 15years are infected with HIV worldwide, mainly in Sub-Saharan Africa. The survival of HIV-infected children depends on their access to antiretroviral therapy whose success mainly depends on a good life-long compliance with antiretroviral therapy. Given its complexity and specificity, assessment and monitoring of pediatric compliance with antiretroviral therapy is a major challenge. There is no consensus on a gold standard for monitoring compliance with antiretroviral therapy. Compliance is also influenced by many factors related to the child, the caregiver, the healthcare staff, the healthcare system, and antiretroviral drugs. This review aimed to assess scientific knowledge on pediatric compliance with antiretroviral therapy in Sub-Saharan Africa, and to identify areas for future interventions to improve compliance. Good compliance is essential to achieve the "90% coverage of children on antiretroviral therapy" gold standard of the World Health Organization, and to eliminate HIV infection by 2030. Copyright © 2017. Published by Elsevier SAS.

[Evaluation of compliance with antiretroviral treatment in a cohort of 200 patients in Djibouti, 2005].

Science.gov (United States)

Ahmed, A A; Katlama, C; Ghosn, J; Guiguet, M; Costagliola, D

2007-01-01

We determined the rate of compliance with antiretroviral therapy and investigated the factors that influence it among 86 HIV patients. Compliance ratio (number of tablets taken/number prescribed) was assessed by tablet count. The mean ratio of compliance was 92%. By tablet count, 77% of the patients were compliant (compliance ratio > or =90%). Non-compliance was significantly associated with side-effects, degree of confidentiality of the care centre and travelling. Compliance correlated significantly with viral load. In multivariate analysis, community support and level of education protected against non-compliance. Patients having already missed a dose and those dissatisfied with confidentiality had a 4 times greater risk of non-compliance.

1995 project of the year Hanford Environmental compliance project nomination

Energy Technology Data Exchange (ETDEWEB)

Kelly, J.R.

1996-02-01

The completion of the Hanford Environmental Compliance (HEC) Project in December 1995 brought to a successful close a long line of major contributions to environmental cleanup. Not since the early days of the Hanford Site during and shortly after World War 11 had such a large group of diverse construction activities, with a common goal, been performed at Hanford. Key to this success was the unique combination of 14 subprojects under the HEC Project which afforded the flexibility to address evolving subproject requirements. This strategy resulted in the accomplishment of the HEC Project stakeholders` objectives on an aggressive schedule, at a $33 million cost savings to the customer. The primary objectives of the HEC Project were to upgrade selected Hanford Site facilities and systems to bring them into compliance with current environmental standards and regulations. The HEC Project contributed significantly towards the Hanford site compliance with Clean Water Act, Resource Conservation and Recovery Act (RCRA) and Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) requirements. It provided, in part, those construction activities required to comply with those requirements in the areas of liquid and solid waste treatment and disposal, waste characterization, and groundwater monitoring.

1995 project of the year Hanford Environmental compliance project nomination

International Nuclear Information System (INIS)

Kelly, J.R.

1996-02-01

The completion of the Hanford Environmental Compliance (HEC) Project in December 1995 brought to a successful close a long line of major contributions to environmental cleanup. Not since the early days of the Hanford Site during and shortly after World War 11 had such a large group of diverse construction activities, with a common goal, been performed at Hanford. Key to this success was the unique combination of 14 subprojects under the HEC Project which afforded the flexibility to address evolving subproject requirements. This strategy resulted in the accomplishment of the HEC Project stakeholders' objectives on an aggressive schedule, at a $33 million cost savings to the customer. The primary objectives of the HEC Project were to upgrade selected Hanford Site facilities and systems to bring them into compliance with current environmental standards and regulations. The HEC Project contributed significantly towards the Hanford site compliance with Clean Water Act, Resource Conservation and Recovery Act (RCRA) and Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) requirements. It provided, in part, those construction activities required to comply with those requirements in the areas of liquid and solid waste treatment and disposal, waste characterization, and groundwater monitoring

Compliance assessment of an uranium hexafluoride package 30B with overpack to the IAEA standards

International Nuclear Information System (INIS)

Andreuccetti, P.; Aquaro, D.; Forasassi, G.; Beone, G.; Eletti, G.; Orsini, A.

1988-01-01

At the Dipartimento di Costruzioni Meccaniche e Nucleari (DCMN) of the Pisa University a research program was carried out in order to assess the compliance to the updated IAEA standards of the UF6 30B container, complete with its sandwich phenolic foam filled external overpack. The research program, performed in collaboration with ENEA and several interested Italian firms, included 9 mt free drop, perforation, thermal and leaktightness tests, on two complete packages with dummy load. The heat transfer conditions, with the UF6 real contents, were simulated by means of numerical analyses with the TRUMP computer code and calculation procedures set up using the available experimental data. The attained results seem to be useful from the point of view of the foreseen purposes

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.

34 CFR 366.63 - What evidence must a center present to demonstrate that it is in minimum compliance with the...

Science.gov (United States)

2010-07-01

... compliance with the evaluation standards? (a) Compliance indicator 1—Philosophy—(1) Consumer control. (i) The... it is in minimum compliance with the evaluation standards? 366.63 Section 366.63 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION CENTERS FOR INDEPENDENT LIVING Evaluation Standards and...

Trans-identity - the Standards of Diagnostics and Treatment

Directory of Open Access Journals (Sweden)

Gessmann H.-V.

2014-11-01

Full Text Available German Society for Sexual Research, Academy of Sexual Medicine and Society of Sexology formulated standards for evaluation and treatment of transsexuals. The creation of the standards involved Sophinette Becker, Hartmut A. G. Bosinski, Ulrich Clement, Wolf Eicher, Thomas M. Goerlich, Uwe Hartmann, Götz Kockott, Dieter Langer, Wilhelm E. Preuss, Gunter Schmidt, Alfred Springer, Reinhard Wille. Since 1980, the Federal Republic of Germany has a law on transsexualism, which regulates the right of the individual to change the sex. However, until now there were no specifically defined standards of assessment and treatment of transsexuals. For the first time, in 1979 Harry Benjamin invited the International Medical Association of Germany to revise the standards of medical care for gender dysphoria. The following standards of assessment and treatment of transsexuals have been developed at a conference convened by the German Society for Research Expert Committee under the leadership of Sophinette Becker. The review of currently valid standards for evaluation and treatment of transgender is the subject of this article

State and Alternative Fuel Provider Fleets - Fleet Compliance Annual Report: Model Year 2015, Fiscal Year 2016

Energy Technology Data Exchange (ETDEWEB)

2016-12-01

The U.S. Department of Energy (DOE) regulates covered state government and alternative fuel provider fleets, pursuant to the Energy Policy Act of 1992 (EPAct), as amended. Covered fleets may meet their EPAct requirements through one of two compliance methods: Standard Compliance or Alternative Compliance. For model year (MY) 2015, the compliance rate with this program for the more than 3011 reporting fleets was 100%. More than 294 fleets used Standard Compliance and exceeded their aggregate MY 2015 acquisition requirements by 8% through acquisitions alone. The seven covered fleets that used Alternative Compliance exceeded their aggregate MY 2015 petroleum use reduction requirements by 46%.

Compliance with self-regulation of television food and beverage advertising aimed at children in Spain.

Science.gov (United States)

Romero-Fernández, Ma Mar; Royo-Bordonada, Miguel Angel; Rodríguez-Artalejo, Fernando

2010-07-01

To evaluate the level of compliance with the PAOS Code (Publicidad, Actividad, Obesidad y Salud), which establishes standards for the self-regulation of food marketing aimed at minors, in television advertising by food and beverage companies that have agreed to abide by the Code. The study sample consisted of food and beverage advertisements targeting children during 80 h of programming by four Spanish television networks. The level of compliance with each standard of the PAOS Code was classified into three categories: 'compliance', 'non-compliance' and 'uncertain compliance'. Overall, an advertisement was considered compliant with the PAOS Code if it met all the standards; non-compliant if it contravened one or more standards; and uncertain in all other cases. Of a total of 203 television advertisements from companies that agreed to the PAOS Code, the overall prevalence of non-compliance was 49.3% (v. 50.8% among those that did not agree to the code), with 20.7% of advertisements considered of uncertain compliance. Non-compliance was more frequent on Saturdays, in longer advertisements, in advertisements containing promotions or dairy products, and for advertisements from companies of French or US origin. Non-compliance with the PAOS Code was very high and was similar for companies that did and did not agree to the Code, casting doubt on the Code's effectiveness and oversight system. It seems the time has come to commit to statutory regulations that reduce the negative impact of advertising on children's diets, as demanded by public health experts and consumer associations.

Compliance determination procedures for environmental radiation protection standards for uranium recovery facilities 40 CFR part 190

International Nuclear Information System (INIS)

1982-03-01

Uranium Milling operations are licensed by the Nuclear Regulatory Commission and by some States in agreement with the Commission. The radiation dose to any individual from the operation of facilities within the uranium fuel cycle is limited to levels set by the Environmental Protection Agency. These levels are contained in the EPA Environmental Radiation Protection Standards for Nuclear Power Operations, in Part 190 of Title 40 of the Code of Federal Regulations (40 CFR Part 190). This report describes the procedures used within NRC's Uranium Recovery Licensing Branch for evaluating compliance with these regulations for uranium milling operations. The report contains descriptions of these procedures, dose factors for evaluating environmental measurement data, and guidance to the NRC staff reviewer

Terminology and reporting criteria for radiofrequency ablation of tumors in the scientific literature: Systematic review of compliance with reporting standards

International Nuclear Information System (INIS)

Kang, Tae Wook; Rhim, Hyun Chul; Lee, Min Woo; Kim, Young Sun; Choi, Dongil; Lim, Hyo Keun

2014-01-01

To perform a systematic review of compliance with standardized terminology and reporting criteria for radiofrequency (RF) tumor ablation, proposed by the International Working Group on Image-Guided Tumor Ablation in 2003, in the published reports. Literature search in the PubMed database was performed using index keywords, PubMed limit system, and eligibility criteria. The entire content of each article was reviewed to assess the terminology used for procedure terms, imaging findings, therapeutic efficacy, follow-up, and complications. Accuracy of the terminology and the use of alternative terms instead of standard terminology were analyzed. In addition, disparities in accuracy of terminology in articles according to the medical specialty and the type of radiology journal were evaluated. Among the articles (n = 308) included in this study, the accuracy of the terms 'procedure or session', 'treatment', 'index tumor', 'ablation zone', 'technical success', 'primary technique effectiveness rate', 'secondary technique effectiveness rate', 'local tumor progression', 'major complication', and 'minor complication' was 97% (298/307), 97% (291/300), 8% (25/307), 65% (103/159), 55% (52/94), 33% (42/129), 94% (17/18), 45% (88/195), 99% (79/80), and 100% (77/77), respectively. The overall accuracy of each term showed a tendency to improve over the years. The most commonly used alternative terms for 'technical success' and 'local tumor progression' were 'complete ablation' and 'local (tumor) recurrence', respectively. The accuracy of terminology in articles published in radiology journals was significantly greater than that of terminology in articles published in non-radiology journals, especially in Radiology and The Journal of Vascular and Interventional Radiology. The proposal for standardization of terminology and reporting criteria for RF tumor ablation has been gaining support according to the recently published scientific reports, especially in the field of radiology

Terminology and reporting criteria for radiofrequency ablation of tumors in the scientific literature: systematic review of compliance with reporting standards.

Science.gov (United States)

Kang, Tae Wook; Rhim, Hyunchul; Lee, Min Woo; Kim, Young-sun; Choi, Dongil; Lim, Hyo Keun

2014-01-01

To perform a systematic review of compliance with standardized terminology and reporting criteria for radiofrequency (RF) tumor ablation, proposed by the International Working Group on Image-Guided Tumor Ablation in 2003, in the published reports. Literature search in the PubMed database was performed using index keywords, PubMed limit system, and eligibility criteria. The entire content of each article was reviewed to assess the terminology used for procedure terms, imaging findings, therapeutic efficacy, follow-up, and complications. Accuracy of the terminology and the use of alternative terms instead of standard terminology were analyzed. In addition, disparities in accuracy of terminology in articles according to the medical specialty and the type of radiology journal were evaluated. Among the articles (n = 308) included in this study, the accuracy of the terms 'procedure or session', 'treatment', 'index tumor', 'ablation zone', 'technical success', 'primary technique effectiveness rate', 'secondary technique effectiveness rate', 'local tumor progression', 'major complication', and 'minor complication' was 97% (298/307), 97% (291/300), 8% (25/307), 65% (103/159), 55% (52/94), 33% (42/129), 94% (17/18), 45% (88/195), 99% (79/80), and 100% (77/77), respectively. The overall accuracy of each term showed a tendency to improve over the years. The most commonly used alternative terms for 'technical success' and 'local tumor progression' were 'complete ablation' and 'local (tumor) recurrence', respectively. The accuracy of terminology in articles published in radiology journals was significantly greater than that of terminology in articles published in non-radiology journals, especially in Radiology and The Journal of Vascular and Interventional Radiology. The proposal for standardization of terminology and reporting criteria for RF tumor ablation has been gaining support according to the recently published scientific reports, especially in the field of radiology

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

QUALITY OF LIFE AND COMPLIANCE TO THERAPY IN PATIENTS FOLLOWING SUCCESSFUL TRANSLUMINAL CORONARY ANGIOPLASTY, WHO WERE PRESCRIBED LESCOL XL (FLUVASTATIN ADDED TO STANDARD THERAPY. RESULTS OF THE LESQOL OPEN-LABEL OBSERVATIONAL STUDY

Directory of Open Access Journals (Sweden)

A. V. Susekov

2010-01-01

Full Text Available Aim. The main aim of the present study was to evaluate quality of life changes and compliance to therapy in patients following successful transluminal angioplasty, who were prescribed fluvastatin extended release in addition to standard treatment.Material and methods. This was a national prospective multicenter observational study. Patients with coronary heart disease following successful transluminal coronary angioplasty, who were prescribed fluvastatin extended release (Lescol Forte, Novartis 80 mg QD were included in the present observation. The following efficacy and safety parameters were evaluated: quality of life evaluated with SF-36 scale before and during treatment; hypolipidemic efficacy, compliance to therapy; adverse events and serious adverse events. Observation period was 6 months in all patients and 12 months in some patients at the discretion of the investigator.Results. 524 patients (79% men and 21% women completed the 6 months observation period and 116 patients were followed up for 12 months. Significant increase of all measures of SF-36 scales, physical and mental health was observed in 6 and 12 months of fluvastatin extended release treatment. Total and low density lipoprotein cholesterol reduction was 30.5% and 54.9% respectively, p<0.01, in 6 months and 34.2% and 34.3% respectively in 12 months of treatment, p<0.01. High density lipoprotein cholesterol was significantly increased by 22.5% in 12 months of treatment, p<0.01. There were very few adverse events and laboratory changes during the course of treatment.Conclusion. LESQOL study showed significant increase in quality of life and good hypolipidemic efficacy as well as good tolerability of fluvastatin extended release in patients after coronary angioplasty.

24 CFR 35.1335 - Standard treatments.

Science.gov (United States)

2010-04-01

... Lead-Paint Hazard Evaluation and Hazard Reduction Activities § 35.1335 Standard treatments. Standard..., such as metal coil stock, plastic, polyurethane, or linoleum. (c) Correcting dust-generating conditions... examination shall be performed in accordance with § 35.1340 at the conclusion of any lead hazard reduction...

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.

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.

Nevada Compliance Implementation and Evaluation Guide

Energy Technology Data Exchange (ETDEWEB)

Cole, Pamala C.

2012-08-30

This Guide is designed to assist state and local code jurisdictions in achieving statewide compliance with the 2009 International Energy Conservation Code (IECC) for residential buildings and ANSI/ASHRAE/IESNA Standard 90.1-2007 for commercial buildings.

Utah Compliance Implementation and Evaluation Guide

Energy Technology Data Exchange (ETDEWEB)

Cole, Pamala C.

2012-08-30

This Guide is designed to assist state and local code jurisdictions in achieving statewide compliance with the 2009 International Energy Conservation Code (IECC) for residential buildings and ANSI/ASHRAE/IESNA Standard 90.1-2007 for commercial buildings.

Iowa Compliance Implementation and Evaluation Guide

Energy Technology Data Exchange (ETDEWEB)

Cole, Pamala C.

2012-09-04

This Guide is designed to assist state and local code jurisdictions in achieving statewide compliance with the 2009 International Energy Conservation Code (IECC) for residential buildings and ANSI/ASHRAE/IESNA Standard 90.1-2007 for commercial buildings.

Towards a standard protocol for antimony intralesional infiltration technique for cutaneous leishmaniasis treatment

Directory of Open Access Journals (Sweden)

Rosiana Estéfane da Silva

Full Text Available BACKGROUND Despite its recognised toxicity, antimonial therapy continues to be the first-line drug for cutaneous leishmaniasis (CL treatment. Intralesional administration of meglumine antimoniate (MA represents an alternative that could reduce the systemic absorption of the drug and its side effects. OBJECTIVES This study aims to validate the standard operational procedure (SOP for the intralesional infiltration of MA for CL therapy as the first step before the assessment of efficacy and safety related to the procedure. METHODS The SOP was created based on 21 trials retrieved from the literature, direct monitoring of the procedure and consultation with experts. This script was submitted to a formal computer-aided inspection to identify readability, clarity, omission, redundancy and unnecessary information (content validation. For criterion and construct validations, the influence of critical condition changes (compliance with the instructions and professional experience on outcome conformity (saturation status achievement, tolerability (pain referred and safety (bleeding were assessed. FINDINGS The median procedure length was 12 minutes and in 72% of them, patients classified the pain as mild. The bleeding was also classified as mild in 96.6% of the procedures. Full compliance with the SOP was observed in 66% of infiltrations. Despite this, in 100% of the inspected procedures, lesion saturation was observed at the end of infiltration, which means that it tolerates some degree of modification in its execution (robustness without prejudice to the result. CONCLUSIONS The procedure is reproducible and can be used by professionals without previous training with high success and safety rates.

Towards a standard protocol for antimony intralesional infiltration technique for cutaneous leishmaniasis treatment.

Science.gov (United States)

Silva, Rosiana Estéfane da; Carvalho, Janaína de Pina; Ramalho, Dario Brock; Senna, Maria Camilo Ribeiro De; Moreira, Hugo Silva Assis; Rabello, Ana; Cota, Erika; Cota, Gláucia

2018-02-01

BACKGROUND Despite its recognised toxicity, antimonial therapy continues to be the first-line drug for cutaneous leishmaniasis (CL) treatment. Intralesional administration of meglumine antimoniate (MA) represents an alternative that could reduce the systemic absorption of the drug and its side effects. OBJECTIVES This study aims to validate the standard operational procedure (SOP) for the intralesional infiltration of MA for CL therapy as the first step before the assessment of efficacy and safety related to the procedure. METHODS The SOP was created based on 21 trials retrieved from the literature, direct monitoring of the procedure and consultation with experts. This script was submitted to a formal computer-aided inspection to identify readability, clarity, omission, redundancy and unnecessary information (content validation). For criterion and construct validations, the influence of critical condition changes (compliance with the instructions and professional experience) on outcome conformity (saturation status achievement), tolerability (pain referred) and safety (bleeding) were assessed. FINDINGS The median procedure length was 12 minutes and in 72% of them, patients classified the pain as mild. The bleeding was also classified as mild in 96.6% of the procedures. Full compliance with the SOP was observed in 66% of infiltrations. Despite this, in 100% of the inspected procedures, lesion saturation was observed at the end of infiltration, which means that it tolerates some degree of modification in its execution (robustness) without prejudice to the result. CONCLUSIONS The procedure is reproducible and can be used by professionals without previous training with high success and safety rates.

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.

Effect of hand sanitizer location on hand hygiene compliance.

Science.gov (United States)

Cure, Laila; Van Enk, Richard

2015-09-01

Hand hygiene is the most important intervention to prevent infection in hospitals. Health care workers should clean their hands at least before and after contact with patients. Hand sanitizer dispensers are important to support hand hygiene because they can be made available throughout hospital units. The aim of this study was to determine whether the usability of sanitizer dispensers correlates with compliance of staff in using the sanitizer in a hospital. This study took place in a Midwest, 404-bed, private, nonprofit community hospital with 15 inpatient care units in addition to several ambulatory units. The usability and standardization of sanitizers in 12 participating inpatient units were evaluated. The hospital measured compliance of staff with hand hygiene as part of their quality improvement program. Data from 2010-2012 were analyzed to measure the relationship between compliance and usability using mixed-effects logistic regression models. The total usability score (P = .0046), visibility (P = .003), and accessibility of the sanitizer on entrance to the patient room (P = .00055) were statistically associated with higher observed compliance rates. Standardization alone showed no significant impact on observed compliance (P = .37). Hand hygiene compliance can be influenced by visibility and accessibility of dispensers. The sanitizer location should be part of multifaceted interventions to improve hand hygiene. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Evaluation of Therapy Management and Patient Compliance in Postmenopausal Patients with Hormone Receptor-positive Breast Cancer Receiving Letrozole Treatment: The EvaluateTM Study

Science.gov (United States)

Fasching, P. A.; Fehm, T.; Kellner, S.; de Waal, J.; Rezai, M.; Baier, B.; Baake, G.; Kolberg, H.-C.; Guggenberger, M.; Warm, M.; Harbeck, N.; Würstlein, R.; Deuker, J.-U.; Dall, P.; Richter, B.; Wachsmann, G.; Brucker, C.; Siebers, J. W.; Fersis, N.; Kuhn, T.; Wolf, C.; Vollert, H.-W.; Breitbach, G.-P.; Janni, W.; Landthaler, R.; Kohls, A.; Rezek, D.; Noesslet, T.; Fischer, G.; Henschen, S.; Praetz, T.; Heyl, V.; Kühn, T.; Krauß, T.; Thomssen, C.; Kümmel, S.; Hohn, A.; Tesch, H.; Mundhenke, C.; Hein, A.; Rauh, C.; Bayer, C. M.; Jacob, A.; Schmidt, K.; Belleville, E.; Hadji, P.; Wallwiener, D.; Grischke, E.-M.; Beckmann, M. W.; Brucker, S. Y.

2014-01-01

Introduction: The EvaluateTM study (Evaluation of therapy management and patient compliance in postmenopausal hormone receptor-positive breast cancer patients receiving letrozole treatment) is a prospective, non-interventional study for the assessment of therapy management and compliance in the routine care of postmenopausal women with invasive hormone receptor-positive breast cancer receiving letrozole. The parameters for inclusion in the study are presented and discussed here. Material and Methods: Between January 2008 and December 2009 a total of 5045 patients in 310 study centers were recruited to the EvaluateTM study. Inclusion criteria were hormone receptor-positive breast cancer and adjuvant treatment or metastasis. 373 patients were excluded from the analysis for various reasons. Results: A total of 4420 patients receiving adjuvant treatment and 252 patients with metastasis receiving palliative treatment were included in the study. For 4181 patients receiving adjuvant treatment, treatment with the aromatase inhibitor letrozole commenced immediately after surgery (upfront). Two hundred patients had initially received tamoxifen and started aromatase inhibitor treatment with letrozole at 1–5 years after diagnosis (switch), und 39 patients only commenced letrozole treatment 5–10 years after diagnosis (extended endocrine therapy). Patient and tumor characteristics were within expected ranges, as were comorbidities and concurrent medication. Conclusion: The data from the EvaluateTM study will offer a good overview of therapy management in the routine care of postmenopausal women with hormone receptor-positive breast cancer. Planned analyses will look at therapy compliance and patient satisfaction with how information is conveyed and the contents of the conveyed information. PMID:25568468

Managing quality and compliance.

Science.gov (United States)

McNeil, Alice; Koppel, Carl

2015-01-01

Critical care nurses assume vital roles in maintaining patient care quality. There are distinct facets to the process including standard setting, regulatory compliance, and completion of reports associated with these endeavors. Typically, multiple niche software applications are required and user interfaces are varied and complex. Although there are distinct quality indicators that must be tracked as well as a list of serious or sentinel events that must be documented and reported, nurses may not know the precise steps to ensure that information is properly documented and actually reaches the proper authorities for further investigation and follow-up actions. Technology advances have permitted the evolution of a singular software platform, capable of monitoring quality indicators and managing all facets of reporting associated with regulatory compliance.

Adesão ao tratamento clínico no transtorno de personalidade borderline Compliance in the treatment of borderline personality disorders

Directory of Open Access Journals (Sweden)

Patrícia Helena Vaz Tanesi

2007-04-01

Full Text Available Adesão é um comportamento complexo, envolve desde pequenas recusas ao tratamento até o uso inadequado dos serviços de saúde e abandono do tratamento. O presente trabalho é um estudo qualitativo com seis pacientes com transtorno de personalidade borderline sobre adesão ao tratamento, utilizando análise qualitativa em entrevista aberta, questionário psicossocial, classificação diagnóstica pela SCID I e II e acompanhamento clínico. Os resultados mostraram que impulsividade, manipulação, dissociação afetiva, tentativa de suicídio, tendência à regressão e agressividade dificultaram ou impossibilitaram a adesão ao tratamento. Concluímos que os casos que abandonaram o tratamento colocaram a equipe em uma situação de impotência e apelo para estratégias sociais como forma de manejo da situação. É levantada a hipótese de que familiares saudáveis podem ser importantes para a adesão ao tratamento. Nos casos que não abandonaram o acompanhamento, a não-adesão se manifestou como ataques ao vínculo, ataques a melhora, e agressividade voltada à equipe e à instituição.Compliance is a complex behavior, ranging from minor instances of treatment refusal to the inappropriate use of health services or even treatment abandonment. The study comprises a qualitative analysis of six patients with borderline personality disorder submitted to an open interview, a psychosocial questionnaire, a diagnostic classification through SCDI I and II and a clinical follow-up. Six behaviors made treatment compliance either difficult or impossible: impulsivity, manipulation, affective dissociation, attempted suicide, tendency to regression, and aggression. The participants who abandoned the treatment made the health team impotent, requiring social strategies to manage the situation. We hypothesized that healthy families are of great importance for compliance to treatment. For the cases in which treatment was not abandoned, non-compliance was

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

Standardization of prostate brachytherapy treatment plans

International Nuclear Information System (INIS)

Ove, Roger; Wallner, Kent; Badiozamani, Kas; Korjsseon, Tammy; Sutlief, Steven

2001-01-01

Purpose: Whereas custom-designed plans are the norm for prostate brachytherapy, the relationship between linear prostate dimensions and volume calls into question the routine need for customized treatment planning. With the goal of streamlining the treatment-planning process, we have compared the treatment margins (TMs) achieved with one standard plan applied to patients with a wide range of prostate volumes. Methods and Materials: Preimplant transrectal ultrasound (TRUS) images of 50 unselected University of Washington patients with T1-T2 cancer and a prostate volume between 20 cc and 50 cc were studied. Patients were arbitrarily grouped into categories of 20-30 cc, 30-40 cc, and 40-50 cc. A standard 19-needle plan was devised for patients in the 30- to 40-cc range, using an arbitrary minimum margin of 5 mm around the gross tumor volume (GTV), making use of inverse planning technology to achieve 100% coverage of the target volume with accentuation of dose at the periphery and sparing of the central region. The idealized plan was applied to each patient's TRUS study. The distances (TMs) between the prostatic edge (GTV) and treated volume (TV) were determined perpendicular to the prostatic margin. Results: Averaged over the entire patient group, the ratio of thickness to width was 1.4, whereas the ratio of length to width was 1.3. These values were fairly constant over the range of volumes, emphasizing that the prostate retains its general shape as volume increases. The idealized standard plan was overlaid on the ultrasound images of the 17 patients in the 30- to 40-cc group and the V100, the percentage of target volume receiving 100% or more of the prescription dose, was 98% or greater for 15 of the 17 patients. The lateral and posterior TMs fell within a narrow range, most being within 2 mm of the idealized 5-mm TM. To estimate whether a 10-cc volume-interval stratification was reasonable, the standard plan generated from the 30- to 40-cc prostate model was

Compliance with diphtheria, tetanus, and pertussis immunisation in Bangladesh

DEFF Research Database (Denmark)

Zeitlyn, S; Rahman, A K; Nielsen, B H

1992-01-01

OBJECTIVE: To evaluate factors associated with non-compliance with having second vaccination against diphtheria, tetanus, and pertussis in a treatment centre in Dhaka to determine which children were most at risk of not completing immunisation. DESIGN: Cohort study of infants given first dose...... of the vaccine and followed up six weeks later to ascertain compliance with having second dose. Factors associated with non-compliance were evaluated. SETTING: Dhaka treatment centre of the International Centre for Diarrhoeal Disease Research, Bangladesh. SUBJECTS: 136 unimmunised children aged 6 weeks to 23...... of immunisation, and she was given clear instructions to bring the child back after four weeks for the second dose. MAIN OUTCOME MEASURE: Rate of non-compliance with advice to return child for second vaccination. RESULTS: 46 of 113 children (41%) received the second dose of the vaccine. Factors most closely...

Advanced Off-Gas Control System Design For Radioactive And Mixed Waste Treatment

International Nuclear Information System (INIS)

Nick Soelberg

2005-01-01

Treatment of radioactive and mixed wastes is often required to destroy or immobilize hazardous constituents, reduce waste volume, and convert the waste to a form suitable for final disposal. These kinds of treatments usually evolve off-gas. Air emission regulations have become increasingly stringent in recent years. Mixed waste thermal treatment in the United States is now generally regulated under the Hazardous Waste Combustor (HWC) Maximum Achievable Control Technology (MACT) standards. These standards impose unprecedented requirements for operation, monitoring and control, and emissions control. Off-gas control technologies and system designs that were satisfactorily proven in mixed waste operation prior to the implementation of new regulatory standards are in some cases no longer suitable in new mixed waste treatment system designs. Some mixed waste treatment facilities have been shut down rather than have excessively restrictive feed rate limits or facility upgrades to comply with the new standards. New mixed waste treatment facilities in the U. S. are being designed to operate in compliance with the HWC MACT standards. Activities have been underway for the past 10 years at the INL and elsewhere to identify, develop, demonstrate, and design technologies for enabling HWC MACT compliance for mixed waste treatment facilities. Some specific off-gas control technologies and system designs have been identified and tested to show that even the stringent HWC MACT standards can be met, while minimizing treatment facility size and cost

Compliance and toxicity of adjuvant CMF in elderly breast cancer patients: a single-center experience

International Nuclear Information System (INIS)

De Maio, Ermelinda; Capasso, Immacolata; Rinaldo, Massimo; Morrica, Brunello; Elmo, Massimo; Di Maio, Massimo; Perrone, Francesco; Matteis, Andrea de; Gravina, Adriano; Pacilio, Carmen; Amabile, Gerardo; Labonia, Vincenzo; Landi, Gabriella; Nuzzo, Francesco; Rossi, Emanuela; D'Aiuto, Giuseppe

2005-01-01

Few data are available on compliance and safety of adjuvant chemotherapy when indicated in elderly breast cancer patients; CMF (cyclophosphamide, methotrexate, fluorouracil) can be reasonably considered the most widely accepted standard of treatment. We retrospectively reviewed compliance and safety of adjuvant CMF in patients older than 60. The treatment was indicated if patients had no severe comorbidity, a high-risk of recurrence, and were younger than 75. Toxicity was coded by NCI-CTC. Toxicity and compliance were compared between two age subgroups (<65, ≥ 65) by Fisher exact test and exact Wilcoxon rank-sum test. From March 1991 to March 2002, 180 patients were identified, 100 older than 60 and younger than 65, and 80 aged 65 or older. Febrile neutropenia was more frequent among older patients (p = 0.05). Leukopenia, neutropenia, nausea, cardiac toxicity and thrombophlebitis tended to be more frequent or severe among elderlies, while mucositis tended to be more evident among younger patients, all not significantly. Almost one half (47%) of the older patients receiving concomitant radiotherapy experienced grade 3–4 haematological toxicity. Compliance was similar in the two groups, with 6 cycles administered in 86% and 79%, day-8 chemotherapy omitted at least once in 36% and 39%, dose reduction in 27% and 38%, prolonged treatment duration (≥ 29 weeks) in 10% and 11% and need of G-CSF in 9% and 18%, among younger and older patients, respectively. Our data show that, in a highly selected population of patients 65 or more years old, CMF is as feasible as in patients older than 60 and younger than 65, but with a relevant burden of toxicity. We suggest that prospective trials in elderly patients testing less toxic treatment schemes are mandatory before indicating adjuvant chemotherapy to all elderly patients with significant risk of breast cancer recurrence

Improving compliance with hormonal replacement therapy in primary osteoporosis prevention

DEFF Research Database (Denmark)

Vestergaard, P; Hermann, A P; Gram, J

1997-01-01

To evaluate whether introduction of treatment alternatives would improve compliance with hormonal replacement therapy (HRT) as primary osteoporosis prevention in women not tolerating the first line osteoporosis prevention schedule.......To evaluate whether introduction of treatment alternatives would improve compliance with hormonal replacement therapy (HRT) as primary osteoporosis prevention in women not tolerating the first line osteoporosis prevention schedule....

Above reproach: developing a comprehensive ethics and compliance program.

Science.gov (United States)

Yuspeh, A; Whalen, K; Cecelic, J; Clifton, S; Cobb, L; Eddy, M; Fainter, J; Packard, J; Postal, S; Steakley, J; Waddey, P

1999-01-01

How can a healthcare organization improve the public's confidence in the conduct of its business operations? What can it do to ensure that it can thrive despite being the subject of public and governmental scrutiny and doubt? Healthcare providers must establish standards of conduct that are above reproach and ensure that those standards are clearly articulated and strictly adhered to. This article describes the merits of a comprehensive ethics and compliance program, suggests five basic elements of such a program--organizational support/structure, setting standards, creating awareness, establishing a mechanism for reporting exceptions, and monitoring and auditing--and then demonstrates how those elements should be applied in several high-risk areas. Fundamentally, an ethics and compliance program has two purposes: to ensure that all individuals in an organization observe pertinent laws and regulations in their work; and to articulate a broader set of aspirational ethical standards that are well-understood within the organization and become a practical guideline for organization members making decisions that raise ethical concerns. Every ethics and compliance program should contain certain fundamental aspects. First, the effort must have the active support of the most senior management in the organization. To instill a commitment to ethics and compliance absent a clear and outspoken commitment to such purposes by organization leaders is simply impossible. Second, an ethics and compliance program is fundamentally about organizational culture--about instilling a commitment to observe the law and, more generally, to do the right thing. Third, ethics and compliance are responsibilities of operating management (sometimes called line management). Although staff such as compliance officers are obligated to provide the necessary resources for a successful program and to design the program, such staff officers cannot achieve implementation and execution. Only operating

Cognitive defenses and compliance with radiation treatment in cancer patients

International Nuclear Information System (INIS)

Karassik, B.M.

1989-01-01

The present study was undertaken to investigate the relationships between four cognitive defenses and compliance with radiation therapy in cancer patients. The role of accurate self-report of usage of each of the defenses was examined as well. A distinction between direct-action and emotion-focused coping was utilized to conceptualize the possible relationships between compliance and the defenses. Based on the proposals of Heilbrun and Renert (1986) regarding the relative evasiveness of the defenses and available evidence from the compliance literature, it was predicted that noncompliant patients would show more repression, projection, and denial and less rationalization than compliant patients. In addition, based upon the findings of Heilbrun and Pepe (1985) that related self-deception to effectiveness of the defenses in dealing with stress, predictions were also made regarding differences in accuracy of reported defense usage by compliant and noncompliant patients. Noncompliant repressors and projectors and compliant rationalizers were predicted to be less aware of their respective use of these defenses than their compliant counterparts; noncompliant deniers were predicted to be more aware of the use of this defense than compliant deniers

Compliance Verification Paths for Residential and Commercial Energy Codes

Energy Technology Data Exchange (ETDEWEB)

Conover, David R.; Makela, Eric J.; Fannin, Jerica D.; Sullivan, Robin S.

2011-10-10

This report looks at different ways to verify energy code compliance and to ensure that the energy efficiency goals of an adopted document are achieved. Conformity assessment is the body of work that ensures compliance, including activities that can ensure residential and commercial buildings satisfy energy codes and standards. This report identifies and discusses conformity-assessment activities and provides guidance for conducting assessments.

Moderate intensity exercise as an adjunct to standard smoking cessation treatment for women: a pilot study.

Science.gov (United States)

Williams, David M; Whiteley, Jessica A; Dunsiger, Shira; Jennings, Ernestine G; Albrecht, Anna E; Ussher, Michael H; Ciccolo, Joseph T; Parisi, Alfred F; Marcus, Bess H

2010-06-01

Previous randomized controlled trials have not supported moderate intensity exercise as an efficacious adjunct to smoking cessation treatments for women; however, compliance with exercise programs in these studies has been poor. The purpose of this pilot study was to estimate the effects of moderate intensity exercise on smoking cessation outcomes under optimal conditions for exercise program compliance. Sixty previously sedentary, healthy, female smokers were randomized to an 8-week program consisting of brief baseline smoking cessation counseling and the nicotine patch plus either 150 min/week of moderate intensity exercise or contact control. Participants attended a median of 86.4% and 95.5% of prescribed exercise/control sessions, respectively. There was a moderate, though statistically nonsignificant, effect of exercise at post-treatment for objectively verified 7-day point prevalence abstinence (48.3% vs. 23.3%; OR = 3.07, 95% CI: 0.89-11.07) and prolonged abstinence (34.5% vs. 20.0%; OR = 2.11, 95% CI: 0.56-8.32). Effects were attenuated when controlling for potential confounders, and after a 1-month, no-treatment period. The findings provide a preliminary indication that, given adequate compliance, moderate intensity exercise may enhance short-term smoking cessation outcomes for women; however, a larger trial is warranted. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

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.

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.

Federal Procurement Standards Applied to School Food Services.

Science.gov (United States)

VanEgmond-Pannell, Dorothy

1984-01-01

Explains standards laid out in Federal Circular A-120 to ensure accountability, uniformity of standards, legal compliance, and efficiency in school food service procurement. Includes bidding and contract award procedures, contract compliance considerations, and cost-cutting methods. (MCG)

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

CROSS COMPLIANCE AND COMPETITIVENESS OF THE EUROPEAN BEEF AND PIG SECTOR

OpenAIRE

de Roest, Kees; Jongeneel, Roelof A.; Dillen, Koen; Winsten, Jonathan R.

2008-01-01

Beef and pig production are important sectors affected by the cross-compliance policy. Full compliance with SMRs and GAECs generates costs and benefits which may have an impact on the competitiveness of these sectors on the world market. Compliance with the Nitrate Directive, animal identification and registration requirements and animal welfare standards can give rise to non-negligible cost of production increases at individual farm level and at sector level. Additional costs can be relevant...

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.

Physiological effects of ovarian hormones: clinical aspects and compliance

DEFF Research Database (Denmark)

Ottesen, B; Pedersen, A T

1996-01-01

of osteoporosis and cardiovascular disease are other considerations. Despite the large number of different hormone treatment regimens available, such problems as continued bleeding and concern about side effects engenders low compliance. To enhance compliance, it is important to ensure that post-menopausal women...

Factors Associated With Non-compliance of Asbestos Occupational Standards in Brake Repair Workers.

Science.gov (United States)

Cely-García, María Fernanda; Curriero, Frank C; Giraldo, Margarita; Méndez, Lorena; Breysse, Patrick N; Durán, Mauricio; Torres-Duque, Carlos A; González-García, Mauricio; Pérez, Carolina; Parada, Patricia; Ramos-Bonilla, Juan Pablo

2016-10-01

Asbestos and non-asbestos containing brake products are currently used in low- and middle-income countries like Colombia. Because brake products are distributed detached from their supports, they require manipulation before installation, which release fibers and expose workers. Previous studies of our research group have documented exposures in excess of the widely accepted 0.1 f/cm(3) exposure guideline. The aim of this study is to identify factors associated with non-compliance of the 8-h time weighted average (TWA) 0.1 f/cm(3) asbestos occupational limit among brake mechanics (i.e. riveters). Eighteen brake repair shops (BRS) located in Bogotá (Colombia) were sampled during 3 to 6 consecutive days for the entire work-shift. Personal and short-term personal samples were collected following NIOSH methods 7400 and 7402. Longitudinal based logistic regression models were used to determine the association between the odds of exceeding the 8-h TWA 0.1 f/cm(3) asbestos occupational limit and variables such as type of tasks performed by workers, workload (number of products manipulated daily), years of experience as riveters, and shop characteristics. These models can be used to estimate the odds of being currently or historically overexposed when sampling data do not exist. Since the information required to run the models can vary for both retrospective and current asbestos occupational exposure studies, three models were constructed with different information requirements. The first model evaluated the association between the odds of non-compliance with variables related to the workload, the second model evaluated the association between the odds of non-compliance with variables related to the manipulation tasks, and the third model evaluated the association between the odds of non-compliance with variables related with both the type of tasks performed by workers and the workload. Variables associated with the odds of non-compliance included conducting at least one

Compliance with removable orthodontic appliances.

Science.gov (United States)

Shah, Nirmal

2017-12-22

be more compliant than older groups. Three studies also found compliance to be better in the early stages of treatment. Integration between quantitative and qualitative studies was not possible.ConclusionsCompliance with removable orthodontic appliances is suboptimal. Patients wear appliances for considerably less time than stipulated and self-reported. Compliance may be increased when patients are aware of monitoring; however, further research is required to identify effective interventions and possible barriers in order to improve removable orthodontic appliance compliance.

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

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

Uncontrolled chronic disease: patient non-compliance or clinical mismanagement?

Science.gov (United States)

Javors, Jonathan R; Bramble, Judith E

2003-01-01

A study group of 30 individuals was randomly chosen from 1,379 beneficiaries predicted to be at risk for health care complications at a large, Midwest, industrial company currently experiencing increased health care costs. All 30 individuals had one or more chronic illness, primarily diabetes, cardiovascular disease, or asthma. Through analysis of medical records, a self-reporting health risk assessment survey, and personal contact with both patients and clinicians, each study individual was assessed as to whether his disease(s) was under control, the individual was compliant with his treatment protocol, and whether the supervising clinician was following nationally accepted standards of care. Fewer than 50% of the individuals in the study group had their chronic illness(es) under control. Those individuals whose treatment adhered to national guidelines were significantly more likely to have their disease under control (p Behavioral (external) barriers were most often cited as the reason a clinical practitioner did not follow the appropriate national standard of care. Most clinicians were aware of and familiar with the guidelines; a few either did not agree with or misunderstood the guidelines. The results of this study suggest that changing clinical practice behaviors to better ensure compliance to national standards of care may make a substantial difference in chronic disease control.

The Efficacy of Saccharomyces boulardii CNCM I-745 in Addition to Standard Helicobacter pylori Eradication Treatment in Children.

Science.gov (United States)

Bin, Zhang; Ya-Zheng, Xu; Zhao-Hui, Deng; Bo, Chu; Li-Rong, Jiang; Vandenplas, Yvan

2015-03-01

This study aims to investigate Saccharomyces boulardii CNCM I-745 during Helicobacter pylori eradication in children. One hundred ninety-four H. pylori positive children were randomized in two groups. Therapy (omeprazole+clarithromycin+amoxicillin or omeprazole+clarithromycin+metronidazole in case of penicillin allergy) was given to both groups during two weeks. In the treatment group (n: 102) S. boulardii was added to the triple therapy, while the control group (n: 92) only received triple therapy. The incidence, onset, duration and severity of diarrhea and compliance to the eradication treatment were compared. A (13)C urea breath test was done 4 weeks after the end of eradication therapy in two groups of 21 patients aged 12 years and older to test the H. pylori eradication rate. In the treatment group, diarrhea occurred in 12 cases (11.76%), starting after 6.25±1.24 days, lasting 3.17±1.08 days, and compliance to eradication treatment was 100%. In the control group, diarrhea occurred in 26 cases (28.26%), starting after 4.05±1.11 days, lasting 4.02±0.87 days, and in six cases eradication treatment was stopped prematurely (p<0.05). The (13)C urea breath test showed successful H. pylori eradication in 71.4% of the patients in the treatment and in 61.9 % in the control group (not significant). S. boulardii has a beneficial effect on the prevention and treatment of diarrhea during H. pylori eradication in children. Although S. boulardii did only slightly increase H. pylori eradication rate, compliance to eradication treatment was improved.

Comprehensive Assessment of Compliance with Antimuscarinic Drug Treatment in the Case of Urge Urinary Incontinence of Older Patients.

Science.gov (United States)

Kosilov, Kirill V; Loparev, Sergey A; Kuzina, Irina G; Shakirova, Olga V; Zhuravskaya, Natalya S; Lobodenko, Alexandra

2017-01-01

To investigate the heterogeneous factors affecting the stability of patients older than 60 years in the UI treatment with Antimuscarinics. The prevalence of Urge Incontinence (UI) in older persons reaches 29.3%. The symptoms of urinary incontinence in older people reduce the health related life quality. In 1257 patients over 60 years (857 (68.2%) women - average age 67.8, 400 (31.8%) men - 71.4), who received AM for one year, demographic, socio-economic and health parameters were studied. OABq-SF questionnaires, MOS SF-36, urination diaries, uroflowmetry, income information from the tax offices and outpatient records were used. The compliance to AM treatment within 6 months was retained in 44.2%, and within the year - 26.8% of older patients. At least 40% of the total number of patients refused to continue the treatment for medical reasons. The persons taking Solifenacin (p≤ 0.01), Trospium (p≤ 0.05), or Darifenacin (p≤ 0.05), suffering from severe UI symptoms (p≤ 0.01), and experiencing minor side effects (p≤ 0.01), well-informed about UI treatment methods (p≤ 0.01) prevailed among the treatment compliant patients. At least 20.4% of the patients discontinued their treatment due to economic reasons. The persons with significantly larger annual income (p≤ 0.05) and annual medical cost (p≤ 0.01) prevailed among the treatment compliant patients. About 12.2% of the patients stopped their treatment for reasons related to the social background and psychological status. In this experiment, we found that AM treatment compliance in older patients, in addition to medical parameters and health conditions, is largely affected by the economic as well as social, demographic and psychological factors. The study results can be claimed by practitioners involved in correcting UI symptoms in older people. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Compliance with technical standards for radiological protection at radiation therapy services in Sao Paulo State, Brazil

International Nuclear Information System (INIS)

Eduardo, Maria Bernadete de Paula; Novaes, Hillegonda Maria Dutilh

2004-01-01

Radiation therapy services provide essential therapeutic procedures for cancer, one of the main causes of population morbidity and mortality. Despite their importance in the health system and their potential risks due to the use of ionizing radiation, there are few studies on such services. We evaluated compliance with technical standards for radiological protection in radiation therapy services in Sao Paulo State, Brazil. Forty-nine services were studied in 2000 through interviews with technical staff. Typologies of performance profiles focusing on structure and process variables were constructed and services compared. Important differences were observed in the services' positions in the health care system, level of complexity, and geographic distribution, with better average performance in structural conditions but very inadequate performance in patient protection, indicating the need for more effective health surveillance. (author)

CROSS-COMPLIANCE Facilitating the CAP reform: Compliance and competitiveness of European agriculture : Specific Targeted Research or Innovation Project (STREP) Integrating and Strengthening the European Research Area

NARCIS (Netherlands)

Jongeneel, R.A.; Bezlepkina, I.; Winsten, J.; Fox, G.

2008-01-01

The prime aim or the project was on assessing the impacts of compliance with standards, more specifically those part of cross-compliance, on EU’s external competitiveness. This is why in several deliverables and also in the main text of this Deliverable 13 a lot of attention is given to the EU and

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

Surgical Process Improvement: Impact of a Standardized Care Model With Electronic Decision Support to Improve Compliance With SCIP Inf-9.

Science.gov (United States)

Cook, David J; Thompson, Jeffrey E; Suri, Rakesh; Prinsen, Sharon K

2014-01-01

The absence of standardization in surgical care process, exemplified in a "solution shop" model, can lead to unwarranted variation, increased cost, and reduced quality. A comprehensive effort was undertaken to improve quality of care around indwelling bladder catheter use following surgery by creating a "focused factory" model within the cardiac surgical practice. Baseline compliance with Surgical Care Improvement Inf-9, removal of urinary catheter by the end of surgical postoperative day 2, was determined. Comparison of baseline data to postintervention results showed clinically important reductions in the duration of indwelling bladder catheters as well as marked reduction in practice variation. Following the intervention, Surgical Care Improvement Inf-9 guidelines were met in 97% of patients. Although clinical quality improvement was notable, the process to accomplish this-identification of patients suitable for standardized pathways, protocol application, and electronic systems to support the standardized practice model-has potentially greater relevance than the specific clinical results. © 2013 by the American College of Medical Quality.

[The role of patient compliance in the management of glaucoma].

Science.gov (United States)

Popović Suić, Smiljka; Cerovski, Branimir; Jukić, Tomislav

2008-02-01

The aim of the study was to evaluate patient cooperation in glaucoma treatment. We evaluated data collected by an anonymous questionnare from 98 glaucoma patients who answered 6 questions regarding their compliance and persistence in glaucoma treatment. Study results revealed 50% of patients to fail taking their antiglaucoma therapy regularly. Patients on monotherapy showed better compliance and higher level of satisfaction with treatment than those on combination antiglaucoma therapy consisting of 2 or 3 eyedrops. Discontinuation of persistence was recorded in 31% of patients, whereas 51% of patients did not present for control visits every six months as suggested by their ophthalmologist. Patients are more compliant and persistent with antiglaucoma monotherapy than with combined therapy. Greater compliance and persistence with ocular hypotensive therapy may improve the outcomes in glaucoma.

Building regulations in energy efficiency: Compliance in England and Wales

International Nuclear Information System (INIS)

Pan Wei; Garmston, Helen

2012-01-01

There is an international pragmatic shift towards the use of building energy regulations, standards and codes to reduce building energy consumption. The UK Government revised Building Regulations in 2002, 2006 and 2010, towards more stringent energy efficiency standards and ultimately the target of ‘zero carbon’ new homes from 2016. This paper aims to: reveal levels of compliance with energy Building Regulations of new-build dwellings in England and Wales; explore underlying issues; and identify possible solutions. In total 376 new-build dwellings were investigated. The compliance revealed was poor, at a level of 35%; accompanied by 43% ‘grey compliance’ and 21% ‘grey non-compliance’ (due to insufficient evidence of achieving required carbon emissions reductions). It is a serious concern when building control approves so many dwellings when insufficient evidence of compliance has been received. Underlying issues were centred on: incorrect compilation and/or insufficient submission of carbon emissions calculations by builders/developers; inappropriate timings of such submissions; and a paucity of proper checks by building control. Exploring these issues reveals a complex system of factors influencing energy regulations compliance, which involves a wide range of stakeholders. The findings should inform the formulation and implementation of energy efficiency building regulations and policy in the future. - Highlights: ► The compliance with energy Building Regulations (England and Wales) was poor. ► The problematic implementation of energy Building Regulations is a serious concern. ► Identified issues suggest a lack of knowledge of builders and building control. ► There is a complex system of factors influencing energy regulations compliance. ► A systems approach is needed to improve compliance, while training is crucial.

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...

Terminology and reporting criteria for radiofrequency ablation of tumors in the scientific literature: Systematic review of compliance with reporting standards

Energy Technology Data Exchange (ETDEWEB)

Kang, Tae Wook; Rhim, Hyun Chul; Lee, Min Woo; Kim, Young Sun; Choi, Dongil; Lim, Hyo Keun [Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2014-02-15

To perform a systematic review of compliance with standardized terminology and reporting criteria for radiofrequency (RF) tumor ablation, proposed by the International Working Group on Image-Guided Tumor Ablation in 2003, in the published reports. Literature search in the PubMed database was performed using index keywords, PubMed limit system, and eligibility criteria. The entire content of each article was reviewed to assess the terminology used for procedure terms, imaging findings, therapeutic efficacy, follow-up, and complications. Accuracy of the terminology and the use of alternative terms instead of standard terminology were analyzed. In addition, disparities in accuracy of terminology in articles according to the medical specialty and the type of radiology journal were evaluated. Among the articles (n = 308) included in this study, the accuracy of the terms 'procedure or session', 'treatment', 'index tumor', 'ablation zone', 'technical success', 'primary technique effectiveness rate', 'secondary technique effectiveness rate', 'local tumor progression', 'major complication', and 'minor complication' was 97% (298/307), 97% (291/300), 8% (25/307), 65% (103/159), 55% (52/94), 33% (42/129), 94% (17/18), 45% (88/195), 99% (79/80), and 100% (77/77), respectively. The overall accuracy of each term showed a tendency to improve over the years. The most commonly used alternative terms for 'technical success' and 'local tumor progression' were 'complete ablation' and 'local (tumor) recurrence', respectively. The accuracy of terminology in articles published in radiology journals was significantly greater than that of terminology in articles published in non-radiology journals, especially in Radiology and The Journal of Vascular and Interventional Radiology. The proposal for standardization of terminology and reporting criteria for

An application of ETICS Co-Scheduling Mechanism to Interoperability and Compliance Validation of Grid Services

CERN Document Server

Ronchieri, Elisabetta; Diez-andino Sancho, Guillermo; DI Meglio, Alberto; Marzolla, Moreno

2008-01-01

Grid software projects require infrastructures in order to evaluate interoperability with other projects and compliance with predefined standards. Interoperability and compliance are quality attributes that are expected from all distributed projects. ETICS is designed to automate the investigation of this kind of problems. It integrates well-established procedures, tools and resources in a coherent framework and adaptes them to the special needs of these projects. Interoperability and compliance to standards are important quality attributes of software developed for Grid environments where many different parts of an interconnected system have to interact. Compliance to standard is one of the major factors in making sure that interoperating parts of a distributed system can actually interconnect and exchange information. Taking the case of the Grid environment (Foster and Kesselman, 2003), most of the projects that are developing software have not reached the maturity level of other communities yet and have di...

12 CFR 30.4 - Filing of safety and soundness compliance plan.

Science.gov (United States)

2010-01-01

... steps the bank will take to correct the deficiency and the time within which those steps will be taken. (c) Review of safety and soundness compliance plans. Within 30 days after receiving a safety and... AND SOUNDNESS STANDARDS § 30.4 Filing of safety and soundness compliance plan. (a) Schedule for filing...

36. The relationship between compliance and quality of life among ...

African Journals Online (AJOL)

Esem

Department of Psychology, University of Zambia. ABSTRACT ... Main outcomes: Compliance to treatment, impact about ... adolescents and also influenced positive behaviour .... Diabetes can affect an adolescent's emotions both directly ... increased risk of depression and anxiety, which may be ... Importance of compliance.

Perspective on demonstrations of compliance for high-level waste disposal

International Nuclear Information System (INIS)

Kocher, D.C.; Smith, E.D.; O'Kelly, G.D.; Sjoreen, A.L.

1984-01-01

This paper discusses a perspective which we have developed on the problem of demonstrating compliance of high-level waste repositories with system performance standards. Our viewpoint arises from two primary concerns - first, that the US Environmental Protection Agency's proposed environmental standard for high-level waste disposal appears to require demonstrations of compliance which are incompatible with scientific knowledge, and, second, that the federal agencies involved in the licensing process may not appreciate fully the extent of unquantifiable and uresolvable uncertainty in repository performance-assessment models. We propose a general approach to demonstrations of compliance which we feel is compatible with the kinds of technical information that will be available for judging repository performance. Our approach emphasizes the importance of investigation alternative conceptual models and lines of reasoning in evaluating repository performance and the importance of subjective scientific judgment in the desision-making process. 24 references, 1 figure

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.

Naval Personnel Can Improve Compliance With the Berry Amendment and the Buy American Act

Science.gov (United States)

2015-08-12

Amendment. Introduction 2 │ DODIG-2015-161 • FSG 83—textiles, leather and furs,6 apparel , and shoes; • FSG 84— clothing , individual equipment and insignia...personnel amended standard operating procedures and internal processes to improve compliance with the Berry Amendment. NAWCAD-Lakehurst personnel...corrective action and amended standard operating procedures and internal processes to improve compliance with the Buy American Act. Additionally, NAWCAD

40 CFR 268.49 - Alternative LDR treatment standards for contaminated soil.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Alternative LDR treatment standards for contaminated soil. 268.49 Section 268.49 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Treatment Standards § 268.49 Alternative LDR treatment standards for contaminated...

Costs, quality of life and treatment compliance associated with antibiotic therapies in patients with cystic fibrosis: a review of the literature.

Science.gov (United States)

Weiner, Jennifer R; Toy, Edmond L; Sacco, Patricia; Duh, Mei Sheng

2008-04-01

Cystic fibrosis is the most common incurable hereditary disease in the US. Persistent respiratory infection is the leading cause of morbidity and mortality in cystic fibrosis patients. This study aimed to review the literature on economic and quality of life outcomes and treatment compliance associated with antibiotic therapies for cystic fibrosis patients. A systematic literature review was conducted using keyword searches of the MEDLINE database and selected conference abstracts. The review covered studies published between January 1990 and May 2007. Evidence suggests that inhaled tobramycin, a key chronic suppressive therapy, can reduce other healthcare costs. The main determinants of the cost of care include disease severity and respiratory infection. Costs vary widely by country. There is evidence that inhaled tobramycin and oral azithromycin improve quality of life and that treatment setting and patient convenience may also impact on quality of life. Antibiotic treatment compliance varied significantly and depended on the method of measurement, with more subjective measures tending to be higher. This review concludes by offering directions for future research.

The Current G20 Taxation Agenda: Compliance, Accountability and Legitimacy

Directory of Open Access Journals (Sweden)

Dries Lesage

2014-11-01

Full Text Available This article analyzes the recent G20 initiatives on taxation, more precisely on “base erosion and profit shifting” (BEPS in the area of corporate taxation and the new G20 norm of automatic exchange of information (AEoI with regard to foreign accounts. After having reflected on the special relationship between the G20 and the OECD, the discussion proceeds through the lens of compliance, accountability and legitimacy. In terms of compliance, the G20 is still in the phase of delivering as a group on recent promises with regard to global standard setting. Compliance to these standards by G20 member states (and third countries is expected to start in the coming years. As to accountability, the G20 and OECD already have ample experience with the peer-review process and public reporting on the G20/OECD standard of information exchange upon request. For AEoI and BEPS the OECD will be designated as the prime mechanism to monitor compliance as well. Both initiatives, which are attempts at universal governance, suffer from legitimacy issues, more precisely because the G20 and OECD exclude most developing countries. Moreover, the policy outputs are not necessarily adjusted to developing countries’ needs and interests. Since a few years, both G20 and OECD attempt to address this issue through institutional fixes, extensive consultations with developing countries and modifications at the level of content.

A natural pharma standard supplement formulation to control treatment-related toxicity and oxidative stress in genitourinary cancer: a preliminary study.

Science.gov (United States)

Ledda, A; Belcaro, G; Dugall, M; Luzzi, R; Hosoi, M; Feragalli, B; Cotellese, R; Cosentino, V; Cosentino, M; Eggenhoffner, R; Pellizzato, M; Fratter, A; Giacomelli, L

2017-09-01

Oncological treatments are associated with toxicities that may decrease compliance to treatment in most genitourinary cancer patients. Supplementation with pharmaceutical-standardized supplement may be a supplementary method to control the side effects after chemo- and radiotherapy and the increased oxidative stress associated to treatments. This registry study evaluated a natural combination of supplements containing curcumin, cordyceps, and astaxanthin (Oncotris™) used as supplementary management in genitourinary cancer patients who had undergone oncological therapy. Patients with genitourinary cancers (prostate or bladder malignancies) who had undergone and completed cancer treatments (radiotherapy, chemotherapy or intravesical immunotherapy with increased oxidative stress and residual symptoms) were recruited in this registry, supplement study. Registry subjects (n = 61) freely decided to follow either a standard management (SM) (control group = 35) or SM plus oral daily supplementation (supplement group = 26). Evaluation of severity of treatment-related residual side effects, blood count test, prostate-specific antigen (PSA) test and plasma free radicals (oxidative stress) were performed at inclusion and at the end of the observational period (6 weeks). Two patients dropped out during the registry. Therefore, the analysis included 59 participants: 26 individuals in the supplementation group and 33 in the control group. In the supplement group, the intensity of signs and symptoms (treatment-related) and residual side effects significantly decreased at 6 weeks: minimal changes were observed in controls. Supplementation with Oncotris™ was associated with a significant improvement in blood cell count and with a decreased level of plasmatic PSA and oxidative stress. Naturally-derived supplements, specifically Oncotris™ (patent pending), could support the body to overcome the treatment-related toxicities - and the relative oxidative stress in cancer patients.

Quality assurance in cancer management. Impact of quality standards on treatment accuracy: The experience of the EORTC

International Nuclear Information System (INIS)

Bernier, J.

1997-01-01

There is thus a need to ensure that the same quality of treatment is offered to all cancer patients in Europe. A research of this kind must be aimed at identifying which steps in the complex treatment processes are more error prove, which of those can most effectively be corrected, and which procedures could be taken over by countries, or individual centers to monitor themselves the quality of their treatment procedures. To achieve this goals, the EORTC Radiotherapy Co-operative Group has put a major effort in the development of two Quality Assurance programs: the Physics Audit program (PAQ) and in the Assurance of Protocol Compliance Program (APCP). In the PAO, a first survey conducted in 1986, on the radiotherapy infrastructure in European Centers participating in clinical trials showed that 20% of the centers encountered difficulties to comply with the EORTC requirements due to imbalance in staff or equipment. Besides radiotherapy infrastructure, the beam output was checked in 50 centers: a major problem was detected in 30% of the checked electron beams. Dosimetric recommendations were sent out to all radio-oncology departments active in the EORTC and a mailed measurement procedure was developed for the verification of the beam output in photon beams. The EORTC Radiotherapy Group has demonstrated that multicenter QA programs permit, through the pooling of a large number of data, auditing by specialists of implemented Quality Standards both in radiation physics and in clinical oncology, contributing to the basis for the development of harmonized quality procedures and standards in the therapeutic management of cancer. This type of QA program should also foster the interaction between several medical disciplines and promote the application of Quality Standards in community level hospitals. Current efforts are also put forth to develop common research instruments, such as the processing of database and MRI or CT-scan images through teleconferencing and the set up

The demand for statin: the effect of copay on utilization and compliance.

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Thiebaud, Patrick; Patel, Bimal V; Nichol, Michael B

2008-01-01

Increasing drug costs in the US have prompted employers and insurers alike to turn to higher drug copays for cost containment. The effect of rising copays on compliance with statins (HMG-CoA reductase inhibitors) treatment has received surprisingly little attention in the applied literature. This paper uses pharmacy claims data from a commercially insured adult population to determine the effect of copay change on compliance at the individual level. Fixed effect logit and Poisson regressions estimate the effect of copays on monthly likelihood of high compliance and average monthly days of supply respectively. Higher copays reduce compliance among statin users, with less compliant patients responding more strongly to copay change than compliant patients. These results suggest that specific financial incentives given to less compliant patients could improve compliance with statin treatment at a relatively low cost. Copyright (c) 2007 John Wiley & Sons, Ltd.

Incentive mechanisms as a strategic option for acid rain compliance

International Nuclear Information System (INIS)

South, D.W.; Bailey, K.A.; McDermott, K.A.

1991-01-01

Title IV of the Clean Air Act Amendments (CAAA) of 1990 (P.L. 101--549) establishes the use of flexible emission compliance strategies for electric utilities to reduce the emissions of add precursors (SO 2 , NO 2 ). To control SO 2 emissions, tradeable emission allowances will be used; NO 2 emissions will be controlled by an emission standard, but a utility is permitted to average NO 2 emissions systemwide to meet the standard. Both of these policies promote flexibility and cost savings for the utility while achieving the prescribed emission reduction goals of P.L. 101--549. The use of SO 2 emission allowances has two notable benefits: A utility has the choice of a wide range of compliance methods allowing it to minimize compliance costs and second; the use of transferable emission allowances promote technological innovation with respect to emissions reduction/control. This report discusses the use of regulatory incentives towards the achievement of a Title IV goal of cost reduction of SO 2 emissions

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.

Managing business compliance using model-driven security management

Science.gov (United States)

Lang, Ulrich; Schreiner, Rudolf

Compliance with regulatory and governance standards is rapidly becoming one of the hot topics of information security today. This is because, especially with regulatory compliance, both business and government have to expect large financial and reputational losses if compliance cannot be ensured and demonstrated. One major difficulty of implementing such regulations is caused the fact that they are captured at a high level of abstraction that is business-centric and not IT centric. This means that the abstract intent needs to be translated in a trustworthy, traceable way into compliance and security policies that the IT security infrastructure can enforce. Carrying out this mapping process manually is time consuming, maintenance-intensive, costly, and error-prone. Compliance monitoring is also critical in order to be able to demonstrate compliance at any given point in time. The problem is further complicated because of the need for business-driven IT agility, where IT policies and enforcement can change frequently, e.g. Business Process Modelling (BPM) driven Service Oriented Architecture (SOA). Model Driven Security (MDS) is an innovative technology approach that can solve these problems as an extension of identity and access management (IAM) and authorization management (also called entitlement management). In this paper we will illustrate the theory behind Model Driven Security for compliance, provide an improved and extended architecture, as well as a case study in the healthcare industry using our OpenPMF 2.0 technology.

The effect of positive and negative message framing on short term continuous positive airway pressure compliance in patients with obstructive sleep apnea.

Science.gov (United States)

Pengo, Martino F; Czaban, Marcin; Berry, Marc P; Nirmalan, Prajeshan; Brown, Richard; Birdseye, Adam; Woroszyl, Asia; Chapman, Julia; Kent, Brian D; Hart, Nicholas; Rossi, Gian Paolo; Steier, Joerg

2018-01-01

Continuous positive airway pressure (CPAP), the best available treatment for obstructive sleep apnea (OSA), requires long-term compliance to be effective. Behavioral interventions may be used to improve adherence to CPAP. We aimed to investigate whether positive or negative message framing impacts on CPAP compliance in patients with OSA, when compared to standard care. Consenting patients with confirmed OSA were randomly allocated to receive along with their CPAP either positively or negatively framed messages (Pos; Neg), or standard care (Con). Standardized motivational messages were read out to patients during an initial teaching session and through weekly telephone calls. Patients' compliance data were reviewed 2 and 6 weeks following CPAP initiation. We randomized 112 patients to groups that were matched for age, BMI, and OSA severity. The positively framed group (Pos) showed greater CPAP usage after 2 weeks (total use 53.7±31.4 hours) as compared to the negatively framed and the control group (35.6±27.4 and 40.8±33.5 hours, Pframed groups (Pos n=5; Neg n=8; Con n=11; Pframed messages can improve CPAP adherence in patients with OSA in the short-term; however, strategies for implementing its long-term use need to be developed.

Treatment compliance and challenges among tuberculosis patients across selected health facilities in Osun State Nigeria.

Science.gov (United States)

Ajao, K O; Ogundun, O A; Afolabi, O T; Ojo, T O; Atiba, B P; Oguntunase, D O

2014-12-01

Tuberculosis (TB) is a major public health problem in the world and Africa has approximately one quarter of the world's cases. One of the greatest challenges facing most TB programmes is the non-compliance to TB treatment among TB patients. This study aimed at determining the challenges of management of tuberculosis (TB) across selected Osun State health facilities. The study employed a descriptive cross-sectional design. A semi-structured questionnaire was used to collect data from 102 TB patients in the health facilities. The instrument measured socio-demographic variables, patient related factors, socio-economic variables, health care system related factors to TB disease and treatment. Data were analysed and summarized using descriptive and inferential statistics. Statistical significance was placed at p facilities (χ2 = 21.761, p facility and patient-related factors were largely responsible.

Monitoramento da adesão ao tratamento com lítio Monitoring the compliance to lithium treatment

Directory of Open Access Journals (Sweden)

Adriane Ribeiro Rosa

2006-01-01

.BACKGROUND: Lithium has been used as the treatment of choice for bipolar disorder. It is efficient in reducing depressive and maniac episodes and has an anti-suicidal effect. However, the effectiveness of lithium is decreased by low compliance to treatment, influenced by patient's characteristics and the pharmacological properties of lithium. OBJECTIVE: To review some of the clinical pharmacological aspects of lithium and its importance for the therapeutic monitoring of lithium, through concentration measurements and through translated to Portuguese self-report scales of non-compliance to lithium treatment. METHOD: Relevant basic and clinical scientific literature available in English and in Portuguese were searched in PUBMED and SCIELO with the words "lithium", "monitoring", "compliance" OR "adherence". RESULTS: Lithium is a drug with very low therapeutic index and difficult individual pharmacokinetic properties, leading to the necessity of intensive therapeutic monitoring, through lithium measurements in serum and in red blood cells. The rates of compliance to lithium prescription by Brazilian bipolar patients who attend outpatient treatment are between 60 and 85%, being higher than those of patients not receiving psychoeducational programs (compliance around 46%. The non-compliant patients present lower knowledge about lithium and their disorder and more negative attitudes toward the use of medication, besides the fear of side-effects. CONCLUSION: Biological monitoring helps in treatment adherence, through the improvement of therapeutic individualization and lithium dose adjustments, besides being helpful in the detection of drugs interactions.

Federal Facility Compliance Act: Conceptual Site Treatment Plan for Lawrence Livermore National Laboratory, Livermore, California

International Nuclear Information System (INIS)

1993-10-01

The Department of Energy (DOE) is required by section 3021(b) of the Resource Conservation and Recovery Act (RCRA), as amended by the Federal Facility Compliance Act (the Act), to prepare plans describing the development of treatment capacities and technologies for treating mixed waste. The Act requires site treatment plans (STPs or plans) to be developed for each site at which DOE generates or stores mixed waste and submitted to the State or EPA for approval, approval with modification, or disapproval. The Lawrence Livermore National Laboratory (LLNL) Conceptual Site Treatment Plan (CSTP) is the preliminary version of the plan required by the Act and is being provided to California, the US Environmental Protection Agency (EPA), and others for review. A list of the other DOE sites preparing CSTPs is included in Appendix 1.1 of this document. Please note that Appendix 1.1 appears as Appendix A, pages A-1 and A-2 in this document

Increased BMI in children-an indicator for less compliance during orthodontic treatment with removable appliances.

Science.gov (United States)

von Bremen, Julia; Lorenz, Nathalie; Ludwig, Björn; Ruf, Sabine

2018-02-19

To assess whether or not childhood overweight is associated with lower levels of compliance during orthodontic therapy with removable appliances. Starting in 2011, all upper expansion plates and Sander II appliances were equipped with a Theramon® microsensor chip to assess appliance wear time objectively. According to their pre-treatment, BMI normal weight patients were matched to consecutively treated overweight or obese patients by gender, age, and appliance type. Cooperation was assessed with microelectronic wear time documentation over a period of at least 6 months. A total of 50 patients (25 overweight, 25 normal weight) with upper expansion plates and 64 patients (32 overweight, 32 normal weight) with Sander II appliances were analysed. Spearman Rho coefficients showed an indirect association between BMI and appliance wear time, indicating that the higher the BMI, the less the patients wore their appliances (P appliances (P appliance wear during orthodontic treatment with removable appliances. Additional factors which influenced cooperation during treatment with removable appliances were patient age and appliance type.

A Systematic, Intensive Statistical Investigation of Data from the Comprehensive Analysis of Reported Drugs (CARD) for Compliance and Illicit Opioid Abstinence in Substance Addiction Treatment with Buprenorphine/naloxone.

Science.gov (United States)

Blum, Kenneth; Han, David; Modestino, Edward J; Saunders, Scott; Roy, A Kennison; Jacobs, W; Inaba, Darryl S; Baron, David; Oscar-Berman, Marlene; Hauser, Mary; Badgaiyan, Rajendra D; Smith, David E; Femino, John; Gold, Mark S

2018-01-28

Buprenorphine and naloxone (bup/nal), a combination partial mu receptor agonist and low-dose delta mu antagonist, is presently recommended and used to treat opioid-use disorder. However, a literature review revealed a paucity of research involving data from urine drug tests that looked at compliance and abstinence in one sample. Statistical analysis of data from the Comprehensive Analysis of Reported Drugs (CARD) was used to assess compliance and abstinence during treatment in a large cohort of bup/nal patients attending chemical-dependency programs from eastern USA in 2010 and 2011. Part 1: Bup/nal was present in 93.4% of first (n = 1,282; p drugs were present in 47.7% (n = 655, p =.0261) of samples. Patients who were compliant to the bup/nal prescription were more likely than noncompliant patients to be abstinent during treatment (p =.0012; odds ratio = 1.69 with 95% confidence interval (1.210, 2.354). Part 2: An analysis of all samples collected in 2011 revealed a significant improvement in both compliance (p < 2.2 × 10 -16 ) and abstinence (p < 2.2 × 10 -16 ) during treatment. Conclusion/Importance: While significant use of illicit opioids during treatment with bup/nal is present, improvements in abstinence and high compliance during maintenance-assisted therapy programs may ameliorate fears of diversion in comprehensive programs. Expanded clinical datasets, the treatment modality, location, and year of sampling are important covariates, for further studies. The potential for long-term antireward effects from bup/nal use requires consideration in future investigations.

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.

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

Social Support of Patients with Type 2 Diabetes in Marginalized Contexts in Mexico and Its Relation to Compliance with Treatment: A Sociocultural Approach

Science.gov (United States)

Juárez-Ramírez, Clara; Théodore, Florence L.; Villalobos, Aremis; Jiménez-Corona, Aida; Lerin, Sergio; Nigenda, Gustavo; Lewis, Sarah

2015-01-01

Objective This study aimed to describe the ways social support works in the daily life of patients with type 2 diabetes living in conditions of social and economic marginality, in order to understand how that support relates to treatment compliance. Methods Sequential mixed methods research was used. The sample of patients was obtained from primary health care units and selected considering regional representativeness, and levels of morbidity and mortality for type 2 diabetes. Results Results point to the nuclear family as the main source of support. Regardless of the area of residence, four main dimensions of support were identified: economic support, help with treatment compliance, emotional support, and material aid. Conclusions We conclude that the support network assists the patient in different ways and helps cope with the disease, but in conditions of social and economic marginality, does not guarantee the quality of attention nor enable the self-management of treatment. PMID:26545122

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.

http://z.umn.edu/INNOVATIONS 2011, Vol. 2, No. 2, Article 45 INNOVATIONS in pharmacy 1 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)

Güvenç Koçkaya, MD

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.

[Validation of the telephone call as a method for measuring compliance to arterial hypertension treatment in Extremadura].

Science.gov (United States)

Espinosa-García, J; Cobaleda-Polo, J; González-Velasco, M; Fernández-Bergés, D

2014-10-01

Pharmacological non-compliance is a significant problem that can affect patient health. The main aim of this investigation is to validate the telephone call to the patient' home as a self-report method of counting the amount of tablets taken by the patient, as an alternative method to a simple tablet count in the clinic (gold standard). An observational, multicentre, prospective, and longitudinal study was conducted by 25 researchers in different health centres in Extremadura, and which included 125 consecutively enrolled patients with uncontrolled arterial hypertension, 121 ended the study. Three visits were made, including enrollment visit, follow-up visit at 4 weeks, and final visit at 8 weeks. A telephone call was made prior to the enrollment and final visit to remind the patients of the next visit, and to ask at the same time about the number of tablets remaining. A total of 121 patients completed the study. In the final visit, the phone-call method of compliance showed: 100% sensitivity, 86% specificity, 86.8% of overall accuracy, 30.4% PPV, 100% NPV, CP+ 7.13, CP- 0.0, and a kappa index of 0.415 (Pphone call, as a therapeutic compliance method, can be a good alternative due to being almost universal, easy to use, its reduced cost, and without the need of patients to go to the medical centres. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Mobile Source Emissions Regulatory Compliance Data Inventory

Science.gov (United States)

The Mobile Source Emissions Regulatory Compliance Data Inventory data asset contains measured summary compliance information on light-duty, heavy-duty, and non-road engine manufacturers by model, as well as fee payment data required by Title II of the 1990 Amendments to the Clean Air Act, to certify engines for sale in the U.S. and collect compliance certification fees. Data submitted by manufacturers falls into 12 industries: Heavy Duty Compression Ignition, Marine Spark Ignition, Heavy Duty Spark Ignition, Marine Compression Ignition, Snowmobile, Motorcycle & ATV, Non-Road Compression Ignition, Non-Road Small Spark Ignition, Light-Duty, Evaporative Components, Non-Road Large Spark Ignition, and Locomotive. Title II also requires the collection of fees from manufacturers submitting for compliance certification. Manufacturers submit data on an annual basis, to document engine model changes for certification. Manufacturers also submit compliance information on already certified in-use vehicles randomly selected by the EPA (1) year into their life and (4) years into their life to ensure that emissions systems continue to function appropriately over time.The EPA performs targeted confirmatory tests on approximately 15% of vehicles submitted for certification. Confirmatory data on engines is associated with its corresponding submission data to verify the accuracy of manufacturer submission beyond standard business rules.Section 209 of the 1990 Amendments to the Clea

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

Patient satisfaction with psychotropic drugs: sensitivity to change and relationship to clinical status, quality-of-life, compliance and effectiveness of treatment. Results from a nation-wide 6-month prospective study.

Science.gov (United States)

Gasquet, Isabelle; Tcherny-Lessenot, Stéphanie; Lépine, Jean-Pierre; Falissard, Bruno

2006-12-01

To see if patient satisfaction with psychotropics (PSP) could be used as a patient-oriented outcome variable in the evaluation of PSP drugs in clinical epidemiological studies, relationships between PSP, clinical status, QoL, compliance and the type of antipsychotic were analyzed. Elements of validation of PSP were also assessed. In a 6-month prospective study, 933 schizophrenic outpatients with initiation or change to their antipsychotic treatment were enrolled. Psychiatrists completed five CGI-SCH scales (positive, negative, cognitive, depressive and global), hospitalization, compliance, and prescription variables. Patients completed PSP, EuroQoL scales, sexual function and compliance variables. A satisfactory structural equation model was obtained showing significant relationships PSP/compliance (coef.=0.16), QoL/PSP (coef.=0.37), clinical status/QoL (coef.=0.61), clinical status/compliance (coef.=0.09). Patients receiving olanzapine were more satisfied than patients receiving other atypicals (coef.=012) and had better clinical status than patients treated with typicals (coef.=0.08). Evolution of PSP was related to clinical status, QoL, and continuation of treatment (all Pmeasure was not sufficiently sensitive to change. Multi-item questionnaires evaluating different dimensions are needed.

Authorization request for potential non-compliance with the American Standard Safety Code for Elevators Dumbwaiters and Escalators

Energy Technology Data Exchange (ETDEWEB)

Boyd, J.E.

1964-09-28

A Third Party inspection of the reactor work platforms was conducted by representatives of the Travelers Insurance Company in 1958. An inspection report submitted by these representatives described hazardous conditions noted and presented a series of recommendations to improve the operational safety of the systems. Project CGI-960, ``C`` & ``D`` Work Platform Safety Improvements -- All Reactors, vas initiated to modify the platforms in compliance with the Third Party recommendations. The American Standard Safety Code for Elevators Dumbwaiters and Escalators (A-17.1) is used as a guide by the Third Party in formulating their recommendations. This code is used because there is no other applicable code for this type of equipment. While the work platforms do not and in some cases can not comply with this code because of operational use, every effort is made to comply with the intent of the code.

Treatment Efficacy and Compliance in Patients with Diabetic Macular Edema Treated with Ranibizumab in a Real-Life Setting

Directory of Open Access Journals (Sweden)

Anne-Laurence Best

2018-01-01

Full Text Available Purpose. To assess real-life efficacy of ranibizumab and treatment compliance of patients with vision loss secondary to diabetic macular edema (DME. Methods. A retrospective study was conducted in DME patients treated with ranibizumab. Patients were monitored every 4 weeks for visual acuity (VA and central retinal thickness (CRT by SD-OCT. All patients received a loading dose of 3 monthly injections followed by retreatments on an as-needed basis. The primary endpoint was the change in VA at M12. Patient compliance to the follow-up and the correlation between the injection number and VA were also investigated. Compliance was compared to that of neovascular age-related macular degeneration (nAMD patients. Results. Seventy-two eyes of 55 consecutive DME patients were included. At baseline, the mean VA was 56.5 letters and CRT was 470 μm. At M12, the mean VA was 63.4 letters (p 70 letters, the mean VA change was +6.9 letters, and the mean CRT was 361.9 μm (p=0.0001 after a mean number of 5.33 intravitreal injections. In patients who received ≥7 injections, the VA gain and final VA were significantly higher than in patients who received <7 injections. At M12, 25.45% of DME patients were lost to follow-up versus 16.8% of nAMD patients (n=55. Discussion/Conclusion. Our study confirms the real-life efficacy of ranibizumab in DME at M12 and the need for a large number of injections to achieve better visual outcomes. We also showed a trend to a lower compliance in diabetic versus nAMD patients.

The Critical Role of Pulmonary Arterial Compliance in Pulmonary Hypertension

Science.gov (United States)

Prins, Kurt W.; Pritzker, Marc R.; Scandurra, John; Volmers, Karl; Weir, E. Kenneth

2016-01-01

The normal pulmonary circulation is a low-pressure, high-compliance system. Pulmonary arterial compliance decreases in the presence of pulmonary hypertension because of increased extracellular matrix/collagen deposition in the pulmonary arteries. Loss of pulmonary arterial compliance has been consistently shown to be a predictor of increased mortality in patients with pulmonary hypertension, even more so than pulmonary vascular resistance in some studies. Decreased pulmonary arterial compliance causes premature reflection of waves from the distal pulmonary vasculature, leading to increased pulsatile right ventricular afterload and eventually right ventricular failure. Evidence suggests that decreased pulmonary arterial compliance is a cause rather than a consequence of distal small vessel proliferative vasculopathy. Pulmonary arterial compliance decreases early in the disease process even when pulmonary artery pressure and pulmonary vascular resistance are normal, potentially enabling early diagnosis of pulmonary vascular disease, especially in high-risk populations. With the recognition of the prognostic importance of pulmonary arterial compliance, its impact on right ventricular function, and its contributory role in the development and progression of distal small-vessel proliferative vasculopathy, pulmonary arterial compliance is an attractive target for the treatment of pulmonary hypertension. PMID:26848601

Regulatory compliance for a Yucca Mountain Repository: A performance assessment perspective

International Nuclear Information System (INIS)

Dyer, J.R.; Van Luik, A.E.; Gil, A.V.; Brocoum, S.J.

1997-01-01

The U.S. Department of Energy's Yucca Mountain Site Characterization Project is scheduled to submit a License Application in the year 2002. The License Application is to show compliance with the regulations promulgated by the U.S. Nuclear Regulatory Commission which implement standards promulgated by the U.S. Environmental Protection Agency. These standards are being revised, and it is not certain what their exact nature will be in term of either the performance measure(s) or the time frames that are to be addressed. This paper provides some insights pertaining to this regulatory history, an update on Yucca Mountain performance assessments, and a Yucca Mountain Site Characterization Project perspective on proper standards based on Project experience in performance assessment for its proposed Yucca Mountain Repository system. The Project's performance assessment based perspective on a proper standard applicable to Yucca Mountain may be summarized as follows: a proper standard should be straight forward and understandable; should be consistent with other standards and regulations; and should require a degree of proof that is scientifically supportable in a licensing setting. A proper standard should have several attributes: (1) propose a reasonable risk level as its basis, whatever the quantitative performance measure is chosen to be, (2) state a definite regulatory time frame for showing compliance with quantitative requirements, (3) explicitly recognize that the compliance calculations are not predictions of actual future risks, (4) define the biosphere to which risk needs to be calculated in such a way as to constrain potentially endless speculation about future societies and future human actions, and (5) have as its only quantitative requirement the risk limit (or surrogate performance measure keyed to risk) for the total system

Predictors of CPAP compliance in different clinical settings: primary care versus sleep unit.

Science.gov (United States)

Nadal, Núria; de Batlle, Jordi; Barbé, Ferran; Marsal, Josep Ramon; Sánchez-de-la-Torre, Alicia; Tarraubella, Nuria; Lavega, Merce; Sánchez-de-la-Torre, Manuel

2018-03-01

Good adherence to continuous positive airway pressure (CPAP) treatment improves the patient's quality of life and decreases the risk of cardiovascular disease. Previous studies that have analyzed the adherence to CPAP were performed in a sleep unit (SU) setting. The involvement of primary care (PC) in the management of obstructive sleep apnea (OSA) patients receiving CPAP treatment could introduce factors related to the adherence to treatment. The objective was to compare the baseline predictors of CPAP compliance in SU and PC settings. OSA patients treated with CPAP were followed for 6 months in SU or PC setting. We included baseline clinical and anthropometrical variables, the Epworth Sleep Scale (ESS) score, the quality of life index, and the Charlson index. A logistic regression was performed for each group to determine the CPAP compliance predictors. Discrimination and calibration were performed using the area under the curve and Hosmer-Lemeshow tests. We included 191 patients: 91 in the PC group and 100 in the SU group. In 74.9% of the patients, the compliance was ≥ 4 h per day, with 80% compliance in the SU setting and 69.2% compliance in the PC setting (p = 0.087). The predictors of CPAP compliance were different between SU and PC settings. Body mass index, ESS, and CPAP pressure were predictors in the SU setting, and ESS, gender, and waist circumference were predictors in the PC setting. The predictors of adequate CPAP compliance vary between SU and PC settings. Detecting compliance predictors could help in the planning of early interventions to improve CPAP adherence.

40 CFR 63.1451 - How do I demonstrate initial compliance with the emission limitations, work practice standards...

Science.gov (United States)

2010-07-01

... compliance status according to the requirements in § 63.1454(e). (f) Venturi wet scrubbers. For each venturi... compliance status that you will operate the venturi wet scrubber within the established operating limits for... baghouse or venturi wet scrubber subject to operating limits in § 63.1444(h) or § 63.1446(e), you have...

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

Progress in implementing the Federal Facility Compliance Act

International Nuclear Information System (INIS)

Bubar, P.; Stone, M.E.

1994-01-01

Hazardous waste and hazardous components of mixed waste require treatment prior to disposal, in accordance with the Resource Conservation and Recovery Act as amended by the Federal Facility Compliance Act. The primary driver for the United States Department of Energy's mixed waste management strategy is the Federal Facility Compliance Act. This Act requires each site generating or storing mixed waste to prepare a treatment plan addressing all mixed waste at the site, with a schedule for treatment capacity construction, and milestones for treating waste when known treatment technologies exist. As of this writing, the Department has published conceptual site treatment plans identifying the technical on-site options and options at other Department or commercial sites. It is now finalizing the Mixed Waste Inventory and Technology Report required by the Act, providing additional detail on its waste streams and treatment capabilities. Now the Department, at its sites, is in the difficult process of winnowing down treatment options in conjunction with the States, with input from the public and other interested parties. Many technical questions, policy and funding issues, and equity concerns among the States must be addressed to enable the Department to propose its preferred treatment options by August 1994

DOTS Compliance by Tuberculosis Patients in District Raipur (Chhattisgarh

Directory of Open Access Journals (Sweden)

Teeku Sinha

2010-10-01

Full Text Available Background: Compliance to therapy is one of the important factors that affect the outcome. Non-compliance to self administered multi drug tuberculosis treatment regimens is an important cause of failure of initial therapy and relapse as well as acquired drug resistance, requiring more prolonged and expensive therapy. Objective: To know the compliance of DOTS therapy in TB patients in District Raipur and to find out the reasons of non-compliance of DOTS therapy among the patients. Study Design: Cross sectional observational community based study. Study Setting: Microscopic Centers in District Raipur. Participants: 695 patients of Tuberculosis. Result: Study revealed that 65.93% patients had complied with the DOTS therapy and 33.38% were non compliant. Conclusion: Most of the reasons of non-Compliance can be averted by proper counseling of target group. Hence to achieve the goal of RNTCP, proper counseling of target group must be given top priority.

Patching compliance with full-time vs. part-time occlusion therapy.

Science.gov (United States)

Kane, Jessica; Biernacki, Ron; Fraine, Lisa; Fukuda, Neva; Haskins, Kelsie; Morrison, David G

2013-01-01

Amblyopia is commonly treated with part-time occlusion (PTO) therapy. We have made two anecdotal observations regarding this therapy. First, children undergoing full-time occlusion seem to have better success and compliance rates. Secondly, a subset of children exists that fail PTO but can improve with more aggressive therapy. A retrospective review where treatment, visual outcome, and compliance scores were recorded. Compliance was graded on percent adherence reported by family. Patients scored “1” (for no compliance), “2” (for 1–25% of prescribed treatment performed), “3” (for 26–50%), “4” (for 51–75%), or “5” (for 76–100%). Seventy-six children were enrolled in the study: forty-five were treated with part-time occlusion, twenty-two were treated with full time occlusion (FTO), and nine had a history of failed PTO and were subsequently treated with FTO. Visual outcomes for FTO versus PTO were not statistically significant (P = 0.82). However, compliance rates in FTO were significantly better (P = 0.02). Of the nine patients that failed PTO, four improved an average of three lines with full-time occlusion, and five had no change with more aggressive patching. This study confirms previous reports of similar visual outcomes between PTO and FTO. However, compliance rates for FTO seem to be higher and some children who have failed PTO may improve with FTO.

Beneficial Effect of Educational and Nutritional Intervention on the Nutritional Status and Compliance of Gastric Cancer Patients Undergoing Chemotherapy: A Randomized Trial.

Science.gov (United States)

Xie, Feng-Lan; Wang, Yong-Qian; Peng, Li-Fen; Lin, Fang-Yu; He, Yu-Long; Jiang, Zhuo-Qin

2017-07-01

Surgery combined with chemotherapy is the standard treatment for gastric cancer (GC); however, chemotherapy-relative adverse effects are common and result in malnutrition and a poor prognosis. In addition, compliance to postoperative chemotherapy remains a problem. This study aimed to prospectively investigate the effect of educational and nutritional interventions on the nutritional status and compliance of GC patients undergoing postoperative chemotherapy. A total of 144 GC patients were randomized into an intervention group that received intensive individualized nutritional and educational interventions during the entire course of chemotherapy and control group that received basic nutrition care and health education during hospitalization. The nutritional status and compliance between the two groups were compared. The interventions significantly improved calorie and iron intake within 24 h after the first chemotherapy session, and improved patients' weight, hemoglobin, total serum protein, and albumin levels during the entire course of chemotherapy. The compliance rate with chemotherapy was significantly higher in the intervention group than in the control group (73.61% vs. 55.56%, P = 0.024). A combination of nutritional and educational interventions provided beneficial effect on the nutrition status and compliance of gastric patients undergoing postoperative chemotherapy, which is worthy of clinical application.

Training Course for Compliance Safety and Health Officers. Final Report.

Science.gov (United States)

McKnight, A. James; And Others

The report describes revision of the Compliance Safety and Health Officers (CSHO) course for the Department of Labor, Occupational Safety and Health Administration (OSHA). The CSHO's job was analyzed in depth, in accord with OSHA standards, policies, and procedures. A listing of over 1,700 violations of OSHA standards was prepared, and specialists…

Cost-Effectiveness Analysis of 1-Year Treatment with Golimumab/Standard Care and Standard Care Alone for Ulcerative Colitis in Poland.

Directory of Open Access Journals (Sweden)

Ewa Stawowczyk

Full Text Available The objective of this study was to assess the cost-effectiveness of induction and maintenance treatment up to 1 year of ulcerative colitis with golimumab/standard care and standard care alone in Poland.A Markov model was used to estimate the expected costs and effects of golimumab/standard care and a standard care alone. For each treatment option the costs and quality adjusted life years were calculated to estimate the incremental cost-utility ratio. The analysis was performed from the perspective of the Polish public payer and society over a 30-years time horizon. The clinical parameters were derived mainly from the PURSUIT-SC and PURSUIT-M clinical trials. Different direct and indirect costs and utility values were assigned to the various model health states.The treatment of ulcerative colitis patients with golimumab/standard care instead of a standard care alone resulted in 0.122 additional years of life with full health. The treatment with golimumab/standard care was found to be more expensive than treatment with the standard care alone from the public payer perspective and from social perspective. The incremental cost-utility ratio of golimumab/standard care compared to the standard care alone is estimated to be 391,252 PLN/QALY gained (93,155 €/QALYG from public payer perspective and 374,377 PLN/QALY gained (89,137 €/QALYG from social perspective.The biologic treatment of ulcerative colitis patients with golimumab/standard care is more effective but also more costly compared with standard care alone.

Review of the performance assessment in the WIPP draft compliance application

International Nuclear Information System (INIS)

Lee, W.W.L.

1996-01-01

On March 31, 1995, the U.S. Department of Energy (USDOE) filed a draft compliance certification application (DCCA) with the U.S. Environmental Protection Agency (USEPA) to show the Waste Isolation Pilot Plant's compliance with the USEPA's environmental standards for disposal of high-level and transuranic waste. Demonstration of compliance is by a performance assessment. This paper is an early review of the performance assessment in the draft application, by the Environmental Evaluation Group, an oversight group. The performance assessment in the draft application is incomplete. Not all relevant scenarios have been analyzed. The calculation of potential consequences often does not use experimental data but rather estimates by workers developing additional data. The final compliance application, scheduled for October 1996, needs to consider additional scenarios, and be fully based on experimental data

Compliance or patient empowerment in online communities

DEFF Research Database (Denmark)

Wentzer, Helle; Bygholm, Ann

2010-01-01

New technologies enable a different organization of the public’s admission to health care services. The article discusses whether online support groups in patient treatment are to be understood in the light of patient empowerment or within the tradition of compliance. The back-ground material...... of opening up health care to the critical voice of the public, the quantitative and qualitative studies surprisingly point to a synthesis of the otherwise opposite positions of empowerment and compliance in patient care. Thereby the critical potential of online communities in health care services seems...

COMPLIANCY AS A MEDICO-SOCIAL AND ETHIC PROBLEM OF PEDIATRICS

Directory of Open Access Journals (Sweden)

G. L. Mikirtichan

2012-01-01

Full Text Available The article represents the clinic-sociological analysis of the compliancy among pediatric patients and the estimation of various factors influence on the patients’ and their surroundings’ adherence to the treatment regimen. For the compliance assessment physicians, children with allergic dermatosis at the age of 13–18 years old (n =295 and their parents (n =270 were interrogated with the special questionnaires. Received data confirms that there is decrease in compliance among the pediatric patients and their patients. It is more significant in older girls than in boys.

A compliance assessment of midpoint formative assessments completed by APPE preceptors.

Science.gov (United States)

Lea Bonner, C; Staton, April G; Naro, Patricia B; McCullough, Elizabeth; Lynn Stevenson, T; Williamson, Margaret; Sheffield, Melody C; Miller, Mindi; Fetterman, James W; Fan, Shirley; Momary, Kathryn M

Experiential pharmacy preceptors should provide formative and summative feedback during a learning experience. Preceptors are required to provide colleges and schools of pharmacy with assessments or evaluations of students' performance. Students and experiential programs value on-time completion of midpoint evaluations by preceptors. The objective of this study was to determine the number of on-time electronically documented formative midpoint evaluations completed by preceptors during advanced pharmacy practice experiences (APPEs). Compliance rates of on-time electronically documented formative midpoint evaluations were reviewed by the Office of Experiential Education of a five-member consortium during the two-year study period prior to the adoption of Standards 2016. Pearson chi-square test and generalized linear models were used to determine if statistically significant differences were present. Average midpoint compliance rates for the two-year research period were 40.7% and 41% respectively. No statistical significance was noted comparing compliance rates for year one versus year two. However, statistical significance was present when comparing compliance rates between schools during year two. Feedback from students and preceptors pointed to the need for brief formal midpoint evaluations that require minimal time to complete, user friendly experiential management software, and methods for documenting verbal feedback through student self-reflection. Additional education and training to both affiliate and faculty preceptors on the importance of written formative feedback at midpoint is critical to remaining in compliance with Standards 2016. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

Technical assessment of compliance with workplace air sampling requirements at WRAP

International Nuclear Information System (INIS)

HACKWORTH, M.F.

1999-01-01

The purpose of this Technical Assessment is to satisfy HSRCM-1, ''Hanford Site Radiological Control Manual'' Article 551.4 for a documented study of facility Workplace Air Monitoring (WAM) programs. HSRCM-1 is the primary guidance for radiological control at Waste Management Federal Services of Hanford, Inc. (WMH). The HSRCM-1 complies with Title 10. Part 835 of the Code of Federal Regulations (10CFR835). This document provides an evaluation of the compliance of the Waste Receiving and Processing facility (WRAP) WAM program to the criteria standards, requirements, and documents compliance with the requirements where appropriate. Where necessary, it also indicates changes needed to bring specific locations into compliance

Compliance with Segment Disclosure Initiatives

DEFF Research Database (Denmark)

Arya, Anil; Frimor, Hans; Mittendorf, Brian

2013-01-01

Regulatory oversight of capital markets has intensified in recent years, with a particular emphasis on expanding financial transparency. A notable instance is efforts by the Financial Accounting Standards Board that push firms to identify and report performance of individual business units...... (segments). This paper seeks to address short-run and long-run consequences of stringent enforcement of and uniform compliance with these segment disclosure standards. To do so, we develop a parsimonious model wherein a regulatory agency promulgates disclosure standards and either permits voluntary...... by increasing transparency and leveling the playing field. However, our analysis also demonstrates that in the long run, if firms are unable to use discretion in reporting to maintain their competitive edge, they may seek more destructive alternatives. Accounting for such concerns, in the long run, voluntary...

The role of pouch compliance measurement in the management of pouch dysfunction

DEFF Research Database (Denmark)

Maeda, Yasuko; Molina, María Elena; Norton, Christine

2010-01-01

PURPOSE: Ileal pouch anal anastomosis is an established option for patients who require total proctocolectomy and restoration of bowel continuity. However, the functional results are not always good and low pouch compliance has been suggested as one possible cause. We aimed to review the results...... of pouch compliance tests over 11 years to assess whether measuring pouch compliance is a useful diagnostic tool to guide management of pouch dysfunction. METHODS: The results of pouch compliance tests performed between 1996 and 2007 together with the details of symptoms, treatments and outcome were...... reviewed. RESULTS: One hundred and forty-one pouch compliance tests were performed. There was no difference in pouch compliance between those with overt pathology (pouchitis, pelvic sepsis or anastomotic stricture) and those with idiopathic pouch dysfunction. In this second group, there was no difference...

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

Subjective and Objective CPAP Compliance in Patients with Obstructive Sleep Apnea Syndrome

Directory of Open Access Journals (Sweden)

Ji-Ae Choi

2011-08-01

Full Text Available Background and Objective This study aimed to investigate objective and subjective continuous positive airway pressure (CPAP compliance in patients with obstructive sleep apnea syndrome (OSAS. Moreover, we evaluated the factors and benefits associated with good CPAP compliance. Methods Subjects were 153 OSAS patients who underwent polysomnography for CPAP titration. Subjective compliance was defined as reported CPAP use of at least 4 hours a day for five or more days per week, and objective compliance was defined as CPAP use of at least 4 hours a day for more than 70% of the time recorded in the CPAP machine. Results The subjective and objective compliance rates were 34.0% and 20.7%, respectively. Subjectively compliant patients had lower minimum O2 saturation and higher % of time with O2 saturation lower than 90% than did patients declining CPAP treatment. Objectively compliant patients had lower insomnia and depression score and lower minimum O2 saturation than did patients declining CPAP treatment. Daytime sleepiness and subjective sleep quality improved to the same extent in both objectively and subjectively compliant patients. Conclusions Lower insomnia score and more severe OSA correlate with good CPAP compliance. CPAP effect was comparable between subjectively and objectively compliant patients.

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...

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)

DOE standard: Radiological control

International Nuclear Information System (INIS)

1999-07-01

The Department of Energy (DOE) has developed this Standard to assist line managers in meeting their responsibilities for implementing occupational radiological control programs. DOE has established regulatory requirements for occupational radiation protection in Title 10 of the Code of Federal Regulations, Part 835 (10 CFR 835), ''Occupational Radiation Protection''. Failure to comply with these requirements may lead to appropriate enforcement actions as authorized under the Price Anderson Act Amendments (PAAA). While this Standard does not establish requirements, it does restate, paraphrase, or cite many (but not all) of the requirements of 10 CFR 835 and related documents (e.g., occupational safety and health, hazardous materials transportation, and environmental protection standards). Because of the wide range of activities undertaken by DOE and the varying requirements affecting these activities, DOE does not believe that it would be practical or useful to identify and reproduce the entire range of health and safety requirements in this Standard and therefore has not done so. In all cases, DOE cautions the user to review any underlying regulatory and contractual requirements and the primary guidance documents in their original context to ensure that the site program is adequate to ensure continuing compliance with the applicable requirements. To assist its operating entities in achieving and maintaining compliance with the requirements of 10 CFR 835, DOE has established its primary regulatory guidance in the DOE G 441.1 series of Guides. This Standard supplements the DOE G 441.1 series of Guides and serves as a secondary source of guidance for achieving compliance with 10 CFR 835

DOE standard: Radiological control

Energy Technology Data Exchange (ETDEWEB)

1999-07-01

The Department of Energy (DOE) has developed this Standard to assist line managers in meeting their responsibilities for implementing occupational radiological control programs. DOE has established regulatory requirements for occupational radiation protection in Title 10 of the Code of Federal Regulations, Part 835 (10 CFR 835), ``Occupational Radiation Protection``. Failure to comply with these requirements may lead to appropriate enforcement actions as authorized under the Price Anderson Act Amendments (PAAA). While this Standard does not establish requirements, it does restate, paraphrase, or cite many (but not all) of the requirements of 10 CFR 835 and related documents (e.g., occupational safety and health, hazardous materials transportation, and environmental protection standards). Because of the wide range of activities undertaken by DOE and the varying requirements affecting these activities, DOE does not believe that it would be practical or useful to identify and reproduce the entire range of health and safety requirements in this Standard and therefore has not done so. In all cases, DOE cautions the user to review any underlying regulatory and contractual requirements and the primary guidance documents in their original context to ensure that the site program is adequate to ensure continuing compliance with the applicable requirements. To assist its operating entities in achieving and maintaining compliance with the requirements of 10 CFR 835, DOE has established its primary regulatory guidance in the DOE G 441.1 series of Guides. This Standard supplements the DOE G 441.1 series of Guides and serves as a secondary source of guidance for achieving compliance with 10 CFR 835.

[Degree of compliance with health care quality criteria in the treatment of lower airway obstruction in Spanish pediatric emergency departments, reasons for noncompliance, and recommendations for improvement].

Science.gov (United States)

Claret Teruel, Gemma; Solé Ribalta, Anna; González Balenciaga, María; Paniagua Calzón, Natalia Marta; Korta Murua, Javier

2016-06-01

To determine the degree of compliance with health care quality criteria in the treatment of patients with lower airway obstruction in Spanish pediatric emergency departments (PEDs), to explore the reasons for noncompliance, and to make recommendations for improvement. We carried out a retrospective, cross-sectional study of a series of patients under the age of 14 years to determine the degree of compliance with 5 quality indicators. The patients were attended in 22 PEDs on days 1 and 15 of each month in 2013. We also distributed a questionnaire to chiefs of department to discover possible reasons for noncompliance. Finally, a group of experts followed a process to produce consensus-based recommendations to improve quality of care through compliance with the indicators. We included 2935 patients with a median (interquartile range) age of 2.8 (1.4-5.1) years. The overall rates of compliance were 39.8% for assessment of severity, 0.1% for measurement of peak flow, 64.4% for delay in attending a patient with severe shortness of breath, 59.1% for checking oxygen saturation and respiratory frequency, and 34.3% for treatment with inhalers and a spacer. The most common reasons for noncompliance were lack of time or material and the absence of the recommendation in protocols. The following improvement steps were recommended: reassess the usefulness of peak flow measurement in PEDs, reformulate the criteria for delay in attending patients with severe dyspnea, and adopt new indicators and templates that facilitate the recording of vital constants and scores on severity scales. An acceptable level of compliance was not achieved on any of the health care quality indicators for a variety of reasons. A series of steps should be taken to improve compliance.

OCONUS Compliance Assessment Protocols - Qatar (Army Version) (CD-ROM)

National Research Council Canada - National Science Library

Krooks, David A

2004-01-01

...: 1 CD-ROM; 4 3/4 in.; 578 KB. ABSTRACT: This environmental compliance assessment manual is based on the Final Governing Standards for Environmental Security of United States Forces in the State of Qatar, 21 May 1999, and the Overseas...

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

Evaluation of the effectiveness and compliance of intermittent preventive treatment (IPT) in the control of malaria in pregnant women in south eastern Nigeria

Science.gov (United States)

Nduka, F O; Nwosu, E; Oguariri, R M

2011-01-01

Controlling malaria in pregnancy has been an important component of the millennium development goal and intermittent preventive treatment (IPT) is considered an important tool in controlling malaria among pregnant women. In this study, we evaluated the level of compliance to IPT use as well as its effect on malaria infection among pregnant women attending antenatal clinic in south eastern Nigeria. Peripheral blood smears and placental histology were used as diagnostic tools to determine infection rate. Our data show that compliance to IPT use was poor (33%) when compared with non-compliance (67%). Infection rate was significantly lower among IPT users (39%) than in non-users (71%) (X2 = 39.95; P<0.05). Maternal anaemia was also lower in IPT users (4%) than in non-users (18%). Taken together, IPT use appears to be important in reducing infection rate and maternal anaemia. Therefore, its adoption is highly recommended and this could be improved through public enlightenment campaign and adequate funding. PMID:22325819

Continuous assessment of carotid intima-media thickness applied to estimate a volumetric compliance using B-mode ultrasound sequences

International Nuclear Information System (INIS)

Pascaner, A F; Craiem, D; Casciaro, M E; Graf, S; Danielo, R; Guevara, E

2015-01-01

Recent reports have shown that the carotid artery wall had significant movements not only in the radial but also in the longitudinal direction during the cardiac cycle. Accordingly, the idea that longitudinal elongations could be systematically neglected for compliance estimations became controversial. Assuming a dynamic change in vessel length, the standard measurement of cross-sectional compliance can be revised. In this work, we propose to estimate a volumetric compliance based on continuous measurements of carotid diameter and intima-media thickness (IMT) from B-mode ultrasound sequences. Assuming the principle of conservation of the mass of wall volume (compressibility equals zero), a temporal longitudinal elongation can be calculated to estimate a volumetric compliance. Moreover, elongations can also be estimated allowing small compressibility factors to model some wall leakage. The cross-sectional and the volumetric compliance were estimated in 45 healthy volunteers and 19 asymptomatic patients. The standard measurement underestimated the volumetric compliance by 25% for young volunteers (p < 0.01) and 17% for patients (p < 0.05). When compressibility factors different from zero were allowed, volunteers and patients reached values of 9% and 4%, respectively. We conclude that a simultaneous assessment of carotid diameter and IMT can be employed to estimate a volumetric compliance incorporating a longitudinal elongation. The cross-sectional compliance, that neglects the change in vessel length, underestimates the volumetric compliance. (paper)

Non-Compliance and Follow-Up in Swedish Official and Private Animal Welfare Control of Dairy Cows

Directory of Open Access Journals (Sweden)

Frida Lundmark Hedman

2018-05-01

Full Text Available Farmers often have to comply with several sets of animal welfare regulations, since private standards have been developed in addition to legislation. Using an epidemiological approach, we analysed protocols from animal welfare inspections carried out in Swedish dairy herds by the County Administrative Board (CAB; official control of legislation and by the dairy company Arla Foods (private control of Arlagården standard during 2010–2013 in the county of Västra Götaland. CAB and Arla inspections were not carried out simultaneously. We aimed to identify common non-compliances, quantify risk factors of non-compliance, and investigate if non-compliances were based on animal-, resource-, or management-based requirements, as well as determining the time period allowed for achieving compliance. Non-compliance was found in 58% of CAB cases, and 51% of Arla cases (each case comprising a sequence of one or several inspections. Dirty dairy cattle was one of the most frequent non-compliances in both control systems. However, the differences in control results were large, suggesting a difference in focus between the two systems. Tie-stall housing and winter season (Dec–Feb were common risk factors for non-compliance, and overall organic farms had a lower predicted number of non-compliances compared to conventional farms. The presence of both similarities and differences between the systems underlines the need for transparency, predictability, and clarity of inspections.

Development and prospects of standardization in the German municipal wastewater sector.

Science.gov (United States)

Freimuth, Claudia; Oelmann, Mark; Amann, Erwin

2018-04-17

Given the significance of wastewater treatment and disposal for society and the economy together with the omnipresence of standards in the sector, we studied the development and prospects of the rules governing standardization in the German municipal wastewater sector. We thereby provide a detailed description of sector-specific committee-based standardization and significantly contribute to the understanding of this complex arena. We find that the German Association for Water Wastewater and Waste (DWA) has significantly improved its rules on standardization over time by aligning them closer to the generally accepted superordinate standardization principles. However, by focusing on theoretical findings of committee decision-making and committee composition, we argue that there is still scope for improvement with respect to rule reading and rule compliance. We show that the incentives at work in standardization committees are manifold, whereas the representation of the different stakeholder groups needs' remains unbalanced. Due to vested interests and potential strategic behavior of the various agents involved in standardization rule compliance does not necessarily happen naturally. To this end, we claim that the implementation of monitoring mechanisms can be a significant contribution to the institutional design of standardization and briefly discuss the advantages and disadvantages of different schemes. Finally, we show that there is ample need for future research on the optimal design of such a scheme. Even though the analysis relates specifically to the DWA our claims apply to a wide range of standards development organizations. Copyright © 2018 Elsevier B.V. All rights reserved.

Scoliosis brace design: influence of visual aesthetics on user acceptance and compliance.

Science.gov (United States)

Law, Derry; Cheung, Mei-Chun; Yip, Joanne; Yick, Kit-Lun; Wong, Christina

2017-06-01

Adolescent idiopathic scoliosis is a common condition found in adolescents. A rigid brace is often prescribed as the treatment for this spinal deformity, which negatively affects user compliance due to the discomfort caused by the brace, and the psychological distress resulting from its appearance. However, the latter, which is the impact of visual aesthetics, has not been thoroughly studied for scoliosis braces. Therefore, a qualitative study with in-depth interviews has been carried out with 10 participants who have a Cobb angle of 20°-30° to determine the impact of visual aesthetics on user acceptance and compliance towards the brace. It is found that co-designing with patients on the aesthetic aspects of the surface design of the brace increases the level of user compliance and induces positive user perception. Therefore, aesthetic preferences need to be taken into consideration in the design process of braces. Practitioner Summary: The impact of visual aesthetics on user acceptance and compliance towards a rigid brace for scoliosis is investigated. The findings indicate that an aesthetically pleasing brace and the involvement of patients in the design process of the brace are important for increasing user compliance and addressing psychological issues during treatment.

TREATMENT COMPLIANCE, IN PATIENS WITH ACUTE CORONARY SYNDROM BEFORE HOSPITALIZATION

Directory of Open Access Journals (Sweden)

Yu. V. Lukina

2012-01-01

, which has demonstrated the contribution of medical (teaching-information, which forms the motivation factor in the problem of treatment compliance.

Environmental effectiveness of GAEC cross-compliance Standard 2.1 ‘Maintaining the level of soil organic matter through management of stubble and crop residues’ and economic evaluation of the competitiveness gap for farmers

Directory of Open Access Journals (Sweden)

Domenico Ventrella

2015-12-01

Full Text Available Within the Project MO.NA.CO. the Environmental effectiveness of GAEC cross-compliance Standard 2.2 ‘Maintaining the level of soil organic matter through management of stubble and crop residues’ and economic evaluation of the competitiveness gap for farmers were evaluated. The monitoring was performed in eight experimental farms of the Council for agricultural research and economics (CREA, distributed throughout Italy and with different soil and climatic conditions. Yield parameters and several components of soil organic matter were evaluated in two contrasting treatments applied to one-year rotation of winter durum wheat and maize: i incorporation into the soil of crop residues (Factual treatment and ii burning or removal of crop residues (Counterfactual treatment. The application of the standard ‘crop residue management’ has showed contrasting results with differences (for yield and soil between the two treatments resulted almost always non significant. The analysis of economic competitiveness gap showed that the CR incorporation is more expensive than CR burning or removal, but the economic disadvantage can be considered rather small and thus easily compensated by Community aids. Therefore, the soil incorporation of crop residues can be considered a ‘good agricultural practice’ that does not penalize farmers in terms of production and cost and at the same time contributes to the maintenance of fertility and soil biodiversity. On the contrary, the removal and burning of residues result in a low or no-addition of organic matter into the soil. Moreover, burning can contribute to decrease the biodiversity and to increase the risk of air pollution, fires and road accidents.

Environmental effectiveness of GAEC cross-compliance standard 2.1 ‘Maintaining the level of soil organic matter through management of stubble and crop residues’ and economic evaluation of the competitiveness gap for farmers

Directory of Open Access Journals (Sweden)

Domenico Ventrella

2015-12-01

Full Text Available Within the Project MO.NA.CO. the Environmental effectiveness of GAEC cross-compliance standard 2.2 ‘Maintaining the level of soil organic matter through management of stubble and crop residues’ and economic evaluation of the competitiveness gap for farmers were evaluated. The monitoring was performed in eight experimental farms of the Council for agricultural research and economics (CREA, distributed throughout Italy and with different soil and climatic conditions. Yield parameters and several components of soil organic matter were evaluated in two contrasting treatments applied to one-year rotation of winter durum wheat and maize: i incorporation into the soil of crop residues (Factual treatment and ii burning or removal of crop residues (Counterfactual treatment. The application of the standard ‘crop residue management’ has showed contrasting results with differences (for yield and soil between the two treatments resulted almost always non significant. The analysis of economic competitiveness gap showed that the CR incorporation is more expensive than CR burning or removal, but the economic disadvantage can be considered rather small and thus easily compensated by Community aids. Therefore, the soil incorporation of crop residues can be considered a ‘good agricultural practice’ that does not penalize farmers in terms of production and cost and at the same time contributes to the maintenance of fertility and soil biodiversity. On the contrary, the removal and burning of residues result in a low or no-addition of organic matter into the soil. Moreover, burning can contribute to decrease the biodiversity and to increase the risk of air pollution, fires and road accidents.

Use of Differential Reinforcement to Increase Hearing Aid Compliance: A Preliminary Investigation

Science.gov (United States)

Bass-Ringdahl, Sandie M.; Ringdahl, Joel E.; Boelter, Eric W.

2010-01-01

Compliance with hearing aid use can be difficult to achieve with children. This difficulty can be increased when a child presents with other disabilities, such as developmental delays. Behavioral treatments, including differential reinforcement, might be one strategy for increasing compliance by these children. In the clinical scenario discussed,…

40 CFR 191.25 - Compliance with other Federal regulations.

Science.gov (United States)

2010-07-01

... SPENT NUCLEAR FUEL, HIGH-LEVEL AND TRANSURANIC RADIOACTIVE WASTES Environmental Standards for Ground... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Compliance with other Federal regulations. 191.25 Section 191.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

Compliance of child care centers in Pennsylvania with national health and safety performance standards for emergency and disaster preparedness.

Science.gov (United States)

Olympia, Robert P; Brady, Jodi; Kapoor, Shawn; Mahmood, Qasim; Way, Emily; Avner, Jeffrey R

2010-04-01

To determine the preparedness of child care centers in Pennsylvania to respond to emergencies and disasters based on compliance with National Health and Safety Performance Standards for Out-of-Home Child Care Programs. A questionnaire focusing on the presence of a written evacuation plan, the presence of a written plan for urgent medical care, the immediate availability of equipment and supplies, and the training of staff in first aid/cardiopulmonary resuscitation (CPR) as delineated in Caring for Our Children: National Health and Safety Performance Standards for Out-of-Home Child Care Programs, 2nd Edition, was mailed to 1000 randomly selected child care center administrators located in Pennsylvania. Of the 1000 questionnaires sent, 496 questionnaires were available for analysis (54% usable response rate). Approximately 99% (95% confidence interval [CI], 99%-100%) of child care centers surveyed were compliant with recommendations to have a comprehensive written emergency plan (WEP) for urgent medical care and evacuation, and 85% (95% CI, 82%-88%) practice their WEP periodically throughout the year. More than 20% of centers did not have specific written procedures for floods, earthquakes, hurricanes, blizzards, or bomb threats, and approximately half of the centers did not have specific written procedures for urgent medical emergencies such as severe bleeding, unresponsiveness, poisoning, shock/heart or circulation failure, seizures, head injuries, anaphylaxis or allergic reactions, or severe dehydration. A minority of centers reported having medications available to treat an acute asthma attack or anaphylaxis. Also, 77% (95% CI, 73%-80%) of child care centers require first aid training for each one of its staff members, and 33% (95% CI, 29%-37%) require CPR training. Although many of the child care centers we surveyed are in compliance with the recommendations for emergency and disaster preparedness, specific areas for improvement include increasing the frequency

Social-skills and parental training plus standard treatment versus standard treatment for children with ADHD - the randomised SOSTRA trial

DEFF Research Database (Denmark)

Simonsen, Erik; Storebø, Ole Jakob; Gluud, Christian

2012-01-01

Objective To investigate the effects of social-skills training and parental training programme for children with attention deficit hyperactivity disorder (ADHD). Methods We conducted a randomized two-armed, parallel group, assessor-blinded superiority trial consisting of social-skills training plus...... parental training and standard treatment versus standard treatment alone. A sample size calculation showed at least 52 children should be included for the trial with follow up three and six months after randomization. The primary outcome measure was ADHD symptoms and secondary outcomes were social skills...... and emotional competences. Results 56 children (39 boys, 17 girls, mean age 10.4 years, SD 1.31) with ADHD were randomized, 28 to the experimental group and 27 to the control group. Mixed-model analyses with repeated measures showed that the time course (y = a + bt + ct2) of ADHD symptoms (p = 0.40), social...

Prognostic value of physicians' assessment of compliance regarding all-cause mortality in patients with type 2 diabetes: primary care follow-up study

Directory of Open Access Journals (Sweden)

Rüter Gernot

2006-07-01

Full Text Available Abstract Background Whether the primary care physician's assessment of patient compliance is a valuable prognostic marker to identify patients who are at increased risk of death, or merely reflects measurement of various treatment parameters such as HbA1C or other laboratory markers is unclear. The objective of this prospective cohort study was to investigate the prognostic value of the physicians' assessment of patient compliance and other factors with respect to all-cause mortality during a one year follow-up period. Methods A prospective cohort study was conducted among 1014 patients with type 2 diabetes aged 40 and over (mean age 69 years, SD 10.4, 45% male who were under medical treatment in 11 participating practices of family physicians and internists working in primary care in a defined region in South Germany between April and June 2000. Baseline data were gathered from patients and physicians by standardized questionnaire. The physician's assessment of patient compliance was assessed by means of a 4-point Likert scale (very good, rather good, rather bad, very bad. In addition, we carried out a survey among physicians by means of a questionnaire to find out which aspects for the assessment of patient compliance were of importance to make this assessment. Active follow-up of patients was conducted after one year to determine mortality. Results During the one year follow-up 48 (4.7% of the 1014 patients died. Among other factors such as patient type (patients presenting at office, nursing home or visited patients, gender, age and a history of macrovascular disease, the physician's assessment of patient compliance was an important predictor of all-cause mortality. Patients whose compliance was assessed by the physician as "very bad" (6% were significantly more likely to die during follow-up (OR = 2.67, 95% CI 1.02–6.97 after multivariable adjustment compared to patients whose compliance was assessed as "rather good" (45% or "very good

Adesão ao tratamento de manutenção em asma (estudo ADERE Compliance with maintenance treatment of asthma (ADERE study

Directory of Open Access Journals (Sweden)

José Miguel Chatkin

2006-08-01

Full Text Available OBJETIVO: Avaliar a adesão ao tratamento preventivo de asma persistente moderada e grave. MÉTODOS: Médicos de vários Estados do país foram contactados para selecionar asmáticos persistentes moderados ou graves, maiores de doze anos. Os pacientes receberam salmeterol/fluticasona 50/250 µg diskus durante 90 dias (sendo orientados a retornarem as embalagens ao final do estudo para conferência da dosagem total utilizada. Receberam telefonemas da equipe do estudo no início e ao final de 90 dias para que fosse avaliada a adesão. Foi considerado como aderente ao tratamento o asmático que utilizou no mínimo 85% das doses prescritas. As variáveis estudadas foram sexo, idade, cor, estado civil, escolaridade, tabagismo atual, outras atopias, co-morbidades, gravidade da asma, uso de outras medicações e número de hospitalizações por asma. RESULTADOS: Foram incluídos 131 pacientes oriundos de quinze estados, com taxa geral de adesão de 51,9%. Houve diferença significativa na adesão quanto à gravidade da asma (maior adesão nos casos graves; p = 0,02. Não houve diferença estatisticamente significativa nas demais variáveis. CONCLUSÃO: A taxa geral de adesão ao tratamento de manutenção da asma foi baixa.OBJECTIVE: To determine the rate of compliance with preventive treatment of moderate and severe persistent asthma. METHODS: Physicians at various medical centers across the country were invited to nominate patients for participation in the study. Inclusion criteria were being over the age of 12 and presenting moderate or severe persistent asthma. Participating patients received salmeterol/fluticasone 50/250 µg by dry powder inhaler for 90 days and were instructed to return the empty packages at the end of the study as a means of determining the total quantity used. In order to evaluate compliance, a member of the research team contacted each patient via telephone at the study outset and again at the end of the 90-day study period

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.

Evolution: Its Treatment in K-12 State Science Curriculum Standards

Science.gov (United States)

Lerner, L. S.

2001-12-01

State standards are the basis upon which states and local schools build curricula. Usually taking the form of lists of what students are expected to learn at specified grades or clusters of grades, they influence statewide examinations, textbooks, teacher education and credentialing, and other areas in which states typically exercise control over local curriculum development. State science standards vary very widely in overall quality.1,2 This is especially true in their treatment of evolution, both in the life sciences and to a somewhat lesser extent in geology and astronomy. Not surprisingly, a detailed evaluation of the treatment of evolution in state science standards3 has evoked considerably more public interest than the preceding studies of overall quality. We here consider the following questions: What constitutes a good treatment of evolution in science standards and how does one evaluate the standards? Which states have done well, and which less well? What nonscientific influences have been brought to bear on standards, for what reasons, and by whom? What strategies have been used to obscure or distort the role of evolution as the central organizing principle of the historical sciences? What are the effects of such distortions on students' overall understanding of science? What can the scientific community do to assure the publication of good science standards and to counteract attacks on good science teaching? 1. Lerner, L. S., State Science Standards: An Appraisal of Science Standards in 36 States, The Thomas B. Fordham Foundation, Washington, D.C., March 1998. 2. Lerner, L. S. et al ., The State of State Standards 2000, ibid., January 2000. 3. Lerner, L. S., Good Science, Bad Science: Teaching Evolution In the States, ibid., September 2000.

Compliance with standard treatment guidelines in the management ...

African Journals Online (AJOL)

Peter Rapula Siko

Introduction: Hypertension is a leading lifestyle disease and major cause of morbidity ... Drug Policy (NDP) in 1996.3,4 This was intended to promote ... through the use of different guidelines for primary health care ..... Elderly Program (SHEP).

Acid rain compliance: Options, facts, and findings

International Nuclear Information System (INIS)

Knutson, K.S.; Metzroth, L.F.; Radjef-Jenatton, M.

1991-01-01

On January 1, 1995, those utilities affected during the Phase 1 implementation of the amended Clean Air Act will be required to comply with new clean air standards. During the next three years leading up to that date, in order to achieve compliance, those companies need to not only decide on a strategy but also implement a plan. To date very few clear-cut compliance decisions have been made. The reasons for the uncertainty center on future fuel prices and the prospects for more efficient and lower cost FGD systems. Many utility planners look at today's coal market and find it hard to believe that prices for some specialty coals, particularly ultra-low sulfur coals, will be higher than the tremendous costs associated with the development of an FGD system. With that in mind, it comes as no surprise that coal switching has been regarded as the least cost choice among even the largest sulfur emitting companies in the country. However, if companies continue to make least cost decisions based on today's coal market, the US coal and utility industries could be in for some disruptive times ahead. While no paper can completely address the enormous complexity surrounding acid rain compliance, this paper addresses some of the broad issues which result from compliance activity and summarizes the findings outlined in RDI's four volume report, the Acid Rain Handbook

Information needs critical to implementing the Federal Facility Compliance Act

Energy Technology Data Exchange (ETDEWEB)

Rasch, D.N. [Department of Energy-Idaho Operations Office, Idaho Falls, ID (United States); Kristofferson, K. [WINCO/INEL, Idaho Falls, ID (United States); Eaton, D.L. [EG& G Idaho/INEL, Idaho Falls, ID (United States)] [and others

1994-12-31

The presented paper summarizes the current status of data collection completed to support the Federal Facility Compliance Act (FFCA) Interim Mixed Waste Inventory Report (IMWIR), current needs, and related lessons learned. The Department of Energy (DOE), as required in Section 3021 of Resource Conservation and Recovery Act (RCRA), is required to prepare waste inventory reports, treatment reports and treatment plans. With this extensive effort, formulation of these requirements has required extensive data collection, validation and revision efforts. The framework for supporting these data needs has been enhanced by establishing a core database capable of supporting the required IMWIR, and has provided the basis for development of the Conceptual Site Treatment Plan (CSTP). The development of the CSTP has shown a need for complex wide standardized information that will ultimately become the basis for major land disposal restriction (LDR) activities such as; site treatment, equity resolution, consent agreement and continued capability to respond to stakeholder requests. DOE is in a position to dramatically demonstrate to the public and the states that mixed waste treatment can be cost effectively realized. To accomplish this program successfully will require use of existing data and expertise. This effort will be enhanced by implementation of basic system management processes which focus on completion of a mutually agreed to goal.

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

Progress in standards for nuclear air and gas treatment

International Nuclear Information System (INIS)

Burchsted, C.A.

1978-01-01

Standardization in nuclear air and gas treatment spans a period of more than 25 years, starting with military specifications for HEPA filters and filter media, and now progressing to the development of a formal code analogous to the ASME Boiler and Pressure Vessel Code. Whereas the current standard for components and installation of nuclear air cleaning systems is limited to safety related facilities for nuclear power plants, the proposed code will cover all types of critical ventilation and air and gas treatment installations for all types of nuclear facilities

76 FR 50286 - Request for Comments and Notice of Public Hearing Concerning China's Compliance With WTO Commitments

Science.gov (United States)

2011-08-12

...., subsidies, standards and technical regulations, sanitary and phytosanitary measures, government procurement... Concerning China's Compliance With WTO Commitments AGENCY: Office of the United States Trade Representative. ACTION: Request for comments and notice of public hearing concerning China's compliance with its WTO...

40 CFR 63.7940 - By what date must I conduct performance tests or other initial compliance demonstrations?

Science.gov (United States)

2010-07-01

... compliance is not demonstrated using a performance test or design evaluation, you must demonstrate initial... performance tests or other initial compliance demonstrations? 63.7940 Section 63.7940 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS...

Oil Mist Compliance

International Nuclear Information System (INIS)

Lazarus, Lloyd

2009-01-01

This report summarizes activities at the KCP related to evaluating and modifying machine tools in order to be in compliance with Section 23 of DOE 10 CFR 851, Worker Safety and Health Program. Section 851.23 (a) states that 'Contractors must comply with the following safety and health standards that are applicable to the hazards in their covered workplace', and subsection 9 contains the following applicable standard: 'American Congress of Governmental Industrial Hygienists (ACGIH), 'Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices,' (2005) (incorporated by reference, see (section)851.27) when the ACGIH Threshold Limit Values are lower (more protective) than permissible exposure limits in 29 CFR 1910'. In the 2005 ACGIH Threshold Limit Value book a Notice of Change was issued for exposure to mineral oil mist used in metalworking fluids (MWFs). The effects of planning for the new facility and which machine tools would be making the transition to the new facility affected which machine tools were modified

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.

EMC Pre-Compliance Tests and Educational Aspects

Directory of Open Access Journals (Sweden)

Lia Elena Aciu

2018-05-01

Full Text Available The aim of this paper is to present the obtained results at the pre-compliance EMC measurements according to the European standards for a microcontroller based device. The EMC measurements fulfils the students’ education in electronics and electrical engineering, who after building microcontroller devices can see the impact on the environment and the immunity to electromagnetic disturbances.

Electron beam collimation with a photon MLC for standard electron treatments

Science.gov (United States)

Mueller, S.; Fix, M. K.; Henzen, D.; Frei, D.; Frauchiger, D.; Loessl, K.; Stampanoni, M. F. M.; Manser, P.

2018-01-01

Standard electron treatments are currently still performed using standard or molded patient-specific cut-outs placed in the electron applicator. Replacing cut-outs and electron applicators with a photon multileaf collimator (pMLC) for electron beam collimation would make standard electron treatments more efficient and would facilitate advanced treatment techniques like modulated electron radiotherapy (MERT) and mixed beam radiotherapy (MBRT). In this work, a multiple source Monte Carlo beam model for pMLC shaped electron beams commissioned at a source-to-surface distance (SSD) of 70 cm is extended for SSDs of up to 100 cm and validated for several Varian treatment units with field sizes typically used for standard electron treatments. Measurements and dose calculations agree generally within 3% of the maximal dose or 2 mm distance to agreement. To evaluate the dosimetric consequences of using pMLC collimated electron beams for standard electron treatments, pMLC-based and cut-out-based treatment plans are created for a left and a right breast boost, a sternum, a testis and a parotid gland case. The treatment plans consist of a single electron field, either alone (1E) or in combination with two 3D conformal tangential photon fields (1E2X). For each case, a pMLC plan with similar treatment plan quality in terms of dose homogeneity to the target and absolute mean dose values to the organs at risk (OARs) compared to a cut-out plan is found. The absolute mean dose to an OAR is slightly increased for pMLC-based compared to cut-out-based 1E plans if the OAR is located laterally close to the target with respect to beam direction, or if a 6 MeV electron beam is used at an extended SSD. In conclusion, treatment plans using cut-out collimation can be replaced by plans of similar treatment plan quality using pMLC collimation with accurately calculated dose distributions.

77 FR 4396 - Petition for Waiver of Compliance

Science.gov (United States)

2012-01-27

... perform and conduct required service and shop inspections, and maintain the cars in compliance with all... from the Railroad Freight Car Safety Standards, 49 CFR 215.303, which requires stenciling on restricted freight cars, for 13 freight cars. The list of these 13 cars is contained in the Exhibit A of the petition...

Compliance, Safety, and Effectiveness of Fixed-Dose Artesunate-Amodiaquine for Presumptive Treatment of Non-Severe Malaria in the Context of Home Management of Malaria in Madagascar

Science.gov (United States)

Ratsimbasoa, Arsène; Ravony, Harintsoa; Vonimpaisomihanta, Jeanne-Aimée; Raherinjafy, Rogelin; Jahevitra, Martial; Rapelanoro, Rabenja; Rakotomanga, Jean De Dieu Marie; Malvy, Denis; Millet, Pascal; Ménard, Didier

2012-01-01

Home management of malaria is recommended for prompt, effective antimalarial treatment in children less than five years of age. Compliance, safety, and effectiveness of the new fixed-dose artesunate-amodiaquine regimen used to treat suspected malaria were assessed in febrile children enrolled in a 24-month cohort study in two settings in Madagascar. Children with fever were asked to visit community health workers. Presumptive antimalarial treatment was given and further visits were scheduled for follow-up. The primary endpoint was the risk of clinical/parasitologic treatment failure. Secondary outcomes included fever/parasite clearance, change in hemoglobin levels, and frequency of adverse events. The global clinical cure rate was 98.4% by day 28 and 97.9% by day 42. Reported compliance was 83.4%. No severe adverse effects were observed. This study provides comprehensive data concerning the clinical cure rate obtained with artesunate-amodiaquine and evidence supporting the scaling up of home management of malaria. PMID:22302849

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.

Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study

Directory of Open Access Journals (Sweden)

Ethy Dorrepaal

2013-11-01

Full Text Available Background: In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD and personality disorders (PDs are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment. Objective: In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment. Method: In a randomized controlled trial on a 20-week stabilizing group cognitive behavioral treatment (CBT for child-abuse-related complex PTSD, we included 71 patients of whom 38 were randomized to a psycho-educational and cognitive behavioral stabilizing group treatment. We compared the patients with few PD symptoms (adaptive (N=14 with the non-adaptive patients (N=24 as revealed by a cluster analysis. Results: We found that non-adaptive patients compared to the adaptive patients showed very low drop-out rates. Both non-adaptive patients, classified with highly different personality profiles “withdrawn” and “aggressive,” were equally compliant. With regard to symptom reduction, we found no significant differences between subtypes. Post-hoc, patients with a PD showed lower drop-out rates and higher effect sizes in terms of complex PTSD severity, especially on domains that affect regulation and interpersonal problems. Conclusion: Contrary to our expectations, these preliminary findings indicate that this treatment is well tolerated by patients with a variety of personality pathology. Larger sample sizes are needed to study effectiveness for subgroups of complex PTSD patients.

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

Municipal Solid Waste Landfills: New Source Performance Standards (NSPS), Emission Guidelines (EG) and Compliance Times

Science.gov (United States)

learn about the NSPS for municipal solid waste landfills by reading the rule summary, rule history, code of federal regulations text, fact sheets, background information documents, related rules and compliance information.

40 CFR 63.5991 - By what date must I conduct an initial compliance demonstration or performance test?

Science.gov (United States)

2010-07-01

... compliance demonstration or performance test? 63.5991 Section 63.5991 Protection of Environment ENVIRONMENTAL... POLLUTANTS FOR SOURCE CATEGORIES National Emissions Standards for Hazardous Air Pollutants: Rubber Tire... initial compliance demonstration or performance test? (a) If you have a new or reconstructed affected...

Laboratory analysis of phacoemulsifier compliance and capacity.

Science.gov (United States)

Nejad, Mitra; Injev, Valentine P; Miller, Kevin M

2012-11-01

To compare the compliance and capacity of 7 fluidics modules used by 6 phacoemulsifiers from 3 manufacturers. Jules Stein Eye Institute, Los Angeles, California, USA. Experimental study. Previous-model and current-model phacoemulsifiers from 3 manufacturers were subjected to laboratory analysis of compliance and capacity. Previous-generation models tested included the Legacy Advantec, Whitestar Sovereign Phacoemulsification System, and Millennium Microsurgical System. Current models tested were the Infiniti Vision System with standard and Intrepid cassettes, Whitestar Signature Phacoemulsification System, and Stellaris Vision Enhancement System. To measure compliance, the aspiration line was connected to an electronic pressure transducer and small volumes of fluid were injected or aspirated. To measure capacity, the space between the distal end of the aspiration line and the pump was filled with methylene blue-dyed fluid. The Legacy was the most compliant phacoemulsifier. The old and new Whitestar systems, Millennium system, and Stellaris system showed similar midrange compliances. The Infiniti Vision System with the Intrepid fluidic management system was the least compliant. The Infiniti cassettes had the greatest capacity, which is a detriment from a surge-control perspective, and Signature cassettes had the least capacity. The Infiniti Intrepid system had the lowest compliance of the 6 units tested, which is optimum from a surge-control perspective. All other things being equal, the Infiniti should have the safest occlusion-break surge response. Mr. Injev is an employee of Alcon Laboratories. Dr. Miller is a consultant to and investigator for Alcon Laboratories. Ms. Nejad has no financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

40 CFR 89.120 - Compliance with emission standards.

Science.gov (United States)

2010-07-01

...). (c) For each nonroad engine family, except Tier 1 engine families with rated power at or above 37 kW... representing an engine family have emissions less than or equal to each emission standard, that family complies with the emission standards. (b) If any test engine representing an engine family has emissions greater...

Non-Compliance and Follow-Up in Swedish Official and Private Animal Welfare Control of Dairy Cows

Science.gov (United States)

Hultgren, Jan; Röcklinsberg, Helena; Wahlberg, Birgitta

2018-01-01

Simple Summary In many cases, different animal welfare inspections are taking place at an animal farm over time, as the farmer has to comply with both the legislation and with various private standards. In this study, we compared official inspections carried out by CAB (the County Administrative Board, a governmental agency) with private inspections carried out by Arla Foods (a private company) on dairy farms in one Swedish county. For example, we looked at seasonal effects and compared the incidence of different non-compliances. This study shows that long time periods were sometimes allowed for correction, that follow-up systems are diverse, and that there were differences in the inspection result between CAB and Arla due to different focuses during the inspections. Dirty dairy cattle were, however, a common non-compliance found by both CAB and Arla. Tie-stall housing and winter season (Dec–Feb) were risk factors for non-compliance, while the risk was lower for both CAB and Arla to find non-compliances at organic farms compared to conventional farms. We conclude that the presence of both similarities and differences between different control systems underlines the need for transparency, predictability, and clarity of inspections. Abstract Farmers often have to comply with several sets of animal welfare regulations, since private standards have been developed in addition to legislation. Using an epidemiological approach, we analysed protocols from animal welfare inspections carried out in Swedish dairy herds by the County Administrative Board (CAB; official control of legislation) and by the dairy company Arla Foods (private control of Arlagården standard) during 2010–2013 in the county of Västra Götaland. CAB and Arla inspections were not carried out simultaneously. We aimed to identify common non-compliances, quantify risk factors of non-compliance, and investigate if non-compliances were based on animal-, resource-, or management-based requirements, as

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)

The Engineering Compliance Program development process and its role in design

International Nuclear Information System (INIS)

1997-12-01

This paper presents an overview of the Engineering Compliance Program (ECP) development process and its role in design. The ECP is a formal program to assess Nuclear Regulatory Commission (NRC) regulatory guidance in terms of precedence, industry experience documents, and codes and standards to determine their applicability to Mined Geologic Disposal System (MGDS) design. These determinations are documented in ECP Guidance Packages for MGDS Structures, Systems and Components (SSCs). This ensures that the license application appropriately reflects the MGDS design and facilitates NRC acceptance and compliance review

Environmental effectiveness of GAEC cross-compliance standard 4.1 (b, c ‘Protection of permanent pasture land’ and economic evaluation of the competitiveness gap for farmers

Directory of Open Access Journals (Sweden)

Mauro Salis

2015-11-01

Full Text Available The paper presents the main results of the monitoring on the effectiveness of the cross-compliance Standard 4.1 ‘Permanent pasture protection: lett. b, c’ carried out in two case studies within the project MO.NA.CO. Soil, botanical, productive and economic (competitiveness gap parameters have been monitored. In the short term, the Standard 4.1 showed its effectiveness on soil quality, biomass productivity and competitiveness gap in both case studies. Botanical parameters showed differing results, therefore their generalization is not applicable to the heterogeneity of the pasture land Italian system. Shallow soil tillage could be suggested, every 40-50 years, when an appropriate soil organic matter content and the absence of runoff phenomena occur.

National Incident Management System (NIMS) Standards Review Panel Workshop Summary Report

Energy Technology Data Exchange (ETDEWEB)

Stenner, Robert D.; Kirk, Jennifer L.; Stanton, James R.; Shebell, Peter; Schwartz, Deborah S.; Judd, Kathleen S.; Gelston, Gariann M.

2006-02-07

The importance and need for full compliant implementation of NIMS nationwide was clearly demonstrated during the Hurricane Katrina event, which was clearly expressed in Secretary Chertoff's October 4, 2005 letter addressed to the State's governors. It states, ''Hurricane Katrina was a stark reminder of how critical it is for our nation to approach incident management in a coordinated, consistent, and efficient manner. We must be able to come together, at all levels of government, to prevent, prepare for, respond to, and recover from any emergency or disaster. Our operations must be seamless and based on common incident management doctrine, because the challenges we face as a nation are far greater than capabilities of any one jurisdiction.'' The NIMS is a system/architecture for organizing response on a ''national'' level. It incorporations ICS as a main component of that structure (i.e., it institutionalizes ICS in NIMS). In a paper published on the NIMS Website, the following statements were made: ''NIMS represents a core set of doctrine, principles, terminology, and organizational processes to enable effective, efficient and collaborative incident management at all levels. To provide the framework for interoperability and compatibility, the NIMS is based on a balance between flexibility and standardization.'' Thus the NIC is challenged with the need to adopt quality SDO generated standards to support NIMS compliance, but in doing so maintain the flexibility necessary so that response operations can be tailored for the specific jurisdictional and geographical needs across the nation. In support of this large and complex challenge facing the NIC, the Pacific Northwest National Laboratory (PNNL) was asked to provide technical support to the NIC, through their DHS Science and Technology ? Standards Portfolio Contract, to help identify, review, and develop key standards for NIMS compliance. Upon

Predictors of compliance with short-term treatment among patients with back pain Factores predictivos del cumplimiento del tratamiento a corto plazo en pacientes con lumbalgia

Directory of Open Access Journals (Sweden)

Neusa Maria Costa Alexandre

2002-08-01

Full Text Available Objective. Great efforts have been made to find effective treatments for back pain. Nevertheless, the effectiveness of a particular treatment can depend on patient compliance. The objective of this study was to prospectively investigate whether patients' demographic factors, clinical factors, external barriers in following the treatment, and perceptions of disability, quality of life, depression, and control over health were predictive of compliance with a physical therapy program carried out with patients with low back pain. Methods. This was an exploratory prospective cohort study that was carried out in New York City during 1999. All study participants answered a questionnaire at the initial clinical evaluation by a physical therapist and were followed during the treatment. The study assessed compliance with the three treatment regimens that were prescribed for every patient: attending scheduled physical therapy sessions, following a program of home exercises, and watching back-education videotapes. Depending on the individual patient, the planned treatment program could last from 2 to 6 weeks. The study employed a battery of instruments to measure patient characteristics that included perceived functional limitations, perceived quality of life, depression, and their beliefs about their health. Student's t tests and chi-square tests were used to determine if non- and low-compliant patients differed significantly from high-compliant patients. Logistic regression was used to estimate adjusted odds ratios expressing the association of selected variables with compliance. Results. We found that 51% of the patients were either noncompliant or low-compliant overall with the low back pain treatment program. There were differences in compliance behavior among the three treatment regimens, with compliance being highest for watching the back-education videotapes and lowest for doing the home exercises. Poor compliance overall was positively associated

Psychometric evaluation of the Polish adaptation of the Hill-Bone Compliance to High Blood Pressure Therapy Scale.

Science.gov (United States)

Uchmanowicz, Izabella; Jankowska-Polańska, Beata; Chudiak, Anna; Szymańska-Chabowska, Anna; Mazur, Grzegorz

2016-05-10

Development of simple instruments for the determination of the level of adherence in patients with high blood pressure is the subject of ongoing research. One such instrument, gaining growing popularity worldwide, is the Hill-Bone Compliance to High Blood Pressure Therapy. The aim of this study was to adapt and to test the reliability of the Polish version of Hill-Bone Compliance to High Blood Pressure Therapy Scale. A standard guideline was used for the translation and cultural adaptation of the English version of the Hill-Bone Compliance to High Blood Pressure Therapy Scale into Polish. The study included 117 Polish patients with hypertension aged between 27 and 90 years, among them 53 men and 64 women. Cronbach's alpha was used for analysing the internal consistency of the scale. The mean score in the reduced sodium intake subscale was M = 5.7 points (standard deviation SD = 1.6 points). The mean score in the appointment-keeping subscale was M = 3.4 points (standard deviation SD = 1.4 points). The mean score in the medication-taking subscale was M = 11.6 points (standard deviation SD = 3.3 points). In the principal component analysis, the three-factor system (1 - medication-taking, 2 - appointment-keeping, 3 - reduced sodium intake) accounted for 53 % of total variance. All questions had factor loadings > 0.4. The medication-taking subscale: most questions (6 out of 9) had the highest loadings with Factor 1. The appointment-keeping subscale: all questions (2 out of 2) had the highest loadings with Factor 2. The reduced sodium intake subscale: most questions (2 out of 3) had the highest loadings with Factor 3. Goodness of fit was tested at chi(2) = 248.87; p High Blood Pressure Therapy Scale proved to be suitable for use in the Polish population. Use of this screening tool for the assessment of adherence to BP treatment is recommended.

49 CFR Appendix A to Part 531 - Example of Calculating Compliance Under § 531.5(c)

Science.gov (United States)

2010-10-01

... 49 Transportation 6 2010-10-01 2010-10-01 false Example of Calculating Compliance Under § 531.5(c) A Appendix A to Part 531 Transportation Other Regulations Relating to Transportation (Continued... FUEL ECONOMY STANDARDS Pt. 531, App. A Appendix A to Part 531—Example of Calculating Compliance Under...

Treatment Compliance with Fixed-Dose Combination of Vildagliptin/Metformin in Patients with Type 2 Diabetes Mellitus Inadequately Controlled with Metformin Monotherapy: A 24-Week Observational Study

Directory of Open Access Journals (Sweden)

Grigorios Rombopoulos

2015-01-01

Full Text Available Objective. To evaluate the differences in treatment compliance with vildagliptin/metformin fixed-dose versus free-dose combination therapy in patients with type 2 diabetes mellitus (T2DM in Greece. Design. Adult patients with T2DM, inadequately controlled with metformin monotherapy, (850 mg bid, participated in this 24-week, multicenter, observational study. Patients were enrolled in two cohorts: vildagliptin/metformin fixed-dose combination (group A and vildagliptin metformin free-dose combination (group B. Results. 659 patients were enrolled, 360 were male, with mean BMI 30.1, mean T2DM duration 59.6 months, and mean HbA1c at baseline 8%; 366 patients were assigned to group A and 293 to group B; data for 3 patients was missing. In group A, 98.9% of patients were compliant with their treatment compared to 84.6% of group B. The odds ratio for compliance in group A versus B was (OR 18.9 (95% CI: 6.2, 57.7; P<0.001. In group A mean HbA1c decreased from 8.1% at baseline to 6.9% (P<0.001 at the study end and from 7.9% to 6.8% (P<0.001 in group B. Conclusions. Patients in group A were more compliant than patients in group B. These results are in accordance with international literature suggesting that fixed-dose combination therapies lead to increased compliance to treatment.

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

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

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

16 CFR 1000.21 - Office of Compliance and Field Operations.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Office of Compliance and Field Operations. 1000.21 Section 1000.21 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL COMMISSION... addressed through rulemaking or voluntary standards. The Office develops surveillance strategies and...

Is treatment outcome improved if patients match themselves to treatment options?

DEFF Research Database (Denmark)

Hell, Morten Ellegaard; Miller, William R; Nielsen, Bent

2018-01-01

standardized measures of alcohol problems: the Addiction Severity Index, Timeline Followback, the World Health Organization quality of life questionnaire, the NEO Five-Factor Inventory 3, and the Personal Happiness Form. For each outcome measure, two analyses will be conducted. Intention-to-treat analyses (ITT....... The primary outcome is decrease in number of monthly excessive drinking days 6 months after initiation of treatment. Secondary outcomes are compliance and 2 quality of life. The influence of personality traits on outcome will also be examined in both groups. DISCUSSION: The debate on matching patients...

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.

[The costs of new drugs compared to current standard treatment].

Science.gov (United States)

Ujeyl, Mariam; Schlegel, Claudia; Gundert-Remy, Ursula

2013-01-01

Until AMNOG came into effect Germany had free pricing of new drugs. Our exemplary work investigates the costs of new drugs that were licensed in the two years prior to AMNOG, and compares them to the costs of standard treatment that has been used in pivotal trials. Also, the important components of pharmaceutical prices will be illustrated. We retrospectively analysed the European Public Assessment Reports of proprietary medicinal products that the European Medicinal Agency initially approved in 2009 and 2010 and that were tested against an active control in at least one pivotal trial. If the standard treatment was a generic, the average pharmacy retail price of new drugs was 7.4 times (median 7.1) higher than that of standard treatment. If the standard treatment was an originator drug the average price was 1.4 times (median 1.2) higher than that of the new drug. There was no clear correlation of an increase in costs for new drugs and their "grade of innovation" as rated according to the criteria of Fricke. Our study shows that prices of new drugs must be linked to the evidence of comparative benefit; since German drug pricing is complex, cost saving effects obtained thereby will depend on a range of other rules and decisions. Copyright © 2013. Published by Elsevier GmbH.

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

OCONUS Compliance Assessment Protocols (OCAP) - Saudi Arabia (Army Version) (CD-ROM)

National Research Council Canada - National Science Library

Krooks, David A; Schell, Donna J

2004-01-01

...: 1 CD-ROM; 4 3/4 in.; 670 KB. ABSTRACT: This environmental compliance assessment manual is based on the Final Governing Standards for Environmental Security by United States Forces in the Kingdom of Saudi Arabia (FGS-SA...

Two-week, high-dose proton pump inhibitor, moxifloxacin triple Helicobacter pylori therapy after failure of standard triple or non-bismuth quadruple treatments.

Science.gov (United States)

Gisbert, Javier P; Romano, Marco; Molina-Infante, Javier; Lucendo, Alfredo J; Medina, Enrique; Modolell, Inés; Rodríguez-Tellez, Manuel; Gomez, Blas; Barrio, Jesús; Perona, Monica; Ortuño, Juan; Ariño, Inés; Domínguez-Muñoz, Juan Enrique; Perez-Aisa, Ángeles; Bermejo, Fernando; Domínguez, Jose Luis; Almela, Pedro; Gomez-Camarero, Judith; Millastre, Judith; Martin-Noguerol, Elisa; Gravina, Antonietta G; Martorano, Marco; Miranda, Agnese; Federico, Alessandro; Fernandez-Bermejo, Miguel; Angueira, Teresa; Ferrer-Barcelo, Luis; Fernández, Nuria; Marín, Alicia C; McNicholl, Adrián G

2015-02-01

Aim was to evaluate the efficacy and tolerability of a moxifloxacin-containing second-line triple regimen in patients whose previous Helicobacter pylori eradication treatment failed. Prospective multicentre study including patients in whom a triple therapy or a non-bismuth-quadruple-therapy failed. Moxifloxacin (400mg qd), amoxicillin (1g bid), and esomeprazole (40 mg bid) were prescribed for 14 days. Eradication was confirmed by (13)C-urea-breath-test. Compliance was determined through questioning and recovery of empty medication envelopes. 250 patients were consecutively included (mean age 48 ± 15 years, 11% with ulcer). Previous (failed) therapy included: standard triple (n = 179), sequential (n = 27), and concomitant (n = 44); 97% of patients took all medications, 4 were lost to follow-up. Intention-to-treat and per-protocol eradication rates were 82.4% (95% CI, 77-87%) and 85.7% (95% CI, 81-90%). Cure rates were similar independently of diagnosis (ulcer, 77%; dyspepsia, 82%) and previous treatment (standard triple, 83%; sequential, 89%; concomitant, 77%). At multivariate analysis, only age was associated with eradication (OR = 0.957; 95% CI, 0.933-0.981). Adverse events were reported in 25.2% of patients: diarrhoea (9.6%), abdominal pain (9.6%), and nausea (9.2%). 14-day moxifloxacin-containing triple therapy is an effective and safe second-line strategy in patients whose previous standard triple therapy or non-bismuth quadruple (sequential or concomitant) therapy has failed, providing a simple alternative to bismuth quadruple regimen. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Comparison of in-and outpatients protocols for providence night time only bracing in AIS patients -- compliance and satisfaction

DEFF Research Database (Denmark)

Al-Aubaidi, Zaid Tj; Tropp, Hans; Pedersen, Niels W

2013-01-01

BACKGROUND: Skeletally immature patients diagnosed with adolescent idiopathic scoliosis (AIS) and a Cobb angle above 25degrees is usually treated with a brace. Standard protocols in many centers include hospitalisation for a few days for the purpose of brace adaptation and fitting. The aim...... of this study is to compare compliance and satisfaction in hospitalization and out patient clinic protocols, at the initiation phase of brace treatment.Materials and methodsTwenty-four consecutive patients with AIS were initiated with the Providence night time only brace at our department between October 2008...

Benefits of statin therapy and compliance in high risk cardiovascular patients

Directory of Open Access Journals (Sweden)

Joel A Lardizabal

2010-09-01

Full Text Available Joel A Lardizabal1, Prakash C Deedwania21Division of Cardiology, Department of Medicine, University of California in San Francisco (Fresno-MEP, Fresno, CA, USA; 2University of California in San Francisco, Chief of Cardiology, Veterans Affairs Central California System, Fresno, CA, USAAbstract: Cardiovascular disease (CVD remains the top cause of global mortality. There is considerable evidence that supports the mortality and morbidity benefit of statin therapy in coronary heart disease (CHD and stroke, both in primary and secondary prevention settings. Data also exist pointing to the advantage of statin treatment in other high-risk CVD conditions, such as diabetes, CKD, CHF, and PVD. National and international clinical guidelines in the management of these CVD conditions all advocate for the utilization of statin therapy in appropriate patients. However, overall compliance to statin therapy remains suboptimal. Patient-, physician-, and economic-related factors all play a role. These factors need to be considered in devising approaches to enhance adherence to guideline-based therapies. To fully reap the benefits of statin therapy, interventions which improve long-term treatment compliance in real-world settings should be encouraged.Keywords: cardiovascular disease, statin therapy, coronary heart disease, long-term treatment compliance

Wireless installation standard

International Nuclear Information System (INIS)

Lim, Hwang Bin

2007-12-01

This is divided six parts which are radio regulation law on securing of radio resource, use of radio resource, protection of radio resource, radio regulation enforcement ordinance with securing, distribution and assignment of radio regulation, radio regulation enforcement regulation on utility of radio resource and technical qualification examination, a wireless installation regulation of technique standard and safety facility standard, radio regulation such as certification regulation of information communicative machines and regulation of radio station on compliance of signal security, radio equipment in radio station, standard frequency station and emergency communication.

Compliance with NRC subsystem requirements in the repository licensing process

International Nuclear Information System (INIS)

Minwalla, H.

1994-01-01

Section 121 of the Nuclear Waste Policy Act of 1982 requires the Nuclear Regulatory Commission (Commission) to issue technical requirements and criteria, for the use of a system of multiple barriers in the design of the repository, that are not inconsistent with any comparable standard promulgated by the Environmental Protection Agency (EPA). The Administrator of the EPA is required to promulgate generally applicable standards for protection of the general environment from offsite releases from radioactive material in repositories. The Commission's regulations pertaining to geologic repositories are provided in 10 CFR part 60. The Commission has provided in 10 CFR 60.112 the overall post-closure system performance objective which is used to demonstrate compliance with the EPA high-level waste (HLW) disposal standard. In addition, the Commission has provided, in 10 CFR 60.113, subsystem performance requirements for substantially complete containment, fractional release rate, and groundwater travel time; however, none of these subsystem performance requirements have a causal technical nexus with the EPA HLW disposal standard. This paper examines the issue of compliance with the conflicting dual regulatory role of subsystem performance requirements in the repository licensing process and recommends several approaches that would appropriately define the role of subsystem performance requirements in the repository licensing process

Prescribed computer games in addition to occlusion versus standard occlusion treatment for childhood amblyopia: a pilot randomised controlled trial.

Science.gov (United States)

Tailor, Vijay K; Glaze, Selina; Khandelwal, Payal; Davis, Alison; Adams, Gillian G W; Xing, Wen; Bunce, Catey; Dahlmann-Noor, Annegret

2015-01-01

Amblyopia ("lazy eye") is the commonest vision deficit in children. If not fully corrected by glasses, amblyopia is treated by patching or blurring the better-seeing eye. Compliance with patching is often poor. Computer-based activities are increasingly topical, both as an adjunct to standard treatment and as a platform for novel treatments. Acceptability by families has not been explored, and feasibility of a randomised controlled trial (RCT) using computer games in terms of recruitment and treatment acceptability is uncertain. We carried out a pilot RCT to test whether computer-based activities are acceptable and accessible to families and to test trial methods such as recruitment and retention rates, randomisation, trial-specific data collection tools and analysis. The trial had three arms: standard near activity advice, Eye Five, a package developed for children with amblyopia, and an off-the-shelf handheld games console with pre-installed games. We enrolled 60 children age 3-8 years with moderate or severe amblyopia after completion of optical treatment. This trial was registered as UKCRN-ID 11074. Pre-screening of 3600 medical notes identified 189 potentially eligible children, of whom 60 remained eligible after optical treatment, and were enrolled between April 2012 and March 2013. One participant was randomised twice and withdrawn from the study. Of the 58 remaining, 37 were boys. The mean (SD) age was 4.6 (1.7) years. Thirty-seven had moderate and 21 severe amblyopia. Three participants were withdrawn at week 6, and in total, four were lost to follow-up at week 12. Most children and parents/carers found the study procedures, i.e. occlusion treatment, usage of the allocated near activity and completion of a study diary, easy. The prescribed cumulative dose of near activity was 84 h at 12 weeks. Reported near activity usage numbers were close to prescribed numbers in moderate amblyopes (94 % of prescribed) but markedly less in severe amblyopes (64

Patients' information-seeking activity is associated with treatment compliance in inflammatory bowel disease patients.

Science.gov (United States)

Pittet, Valérie; Rogler, Gerhard; Mottet, Christian; Froehlich, Florian; Michetti, Pierre; de Saussure, Philippe; Burnand, Bernard; Vader, John-Paul

2014-06-01

Despite the chronic and relapsing nature of inflammatory bowel diseases (IBD), at least 30% to 45% of the patients are noncompliant to treatment. IBD patients often seek information about their disease. To examine the association between information-seeking activity and treatment compliance among IBD patients. To compare information sources and concerns between compliant and noncompliant patients. We used data from the Swiss IBD cohort study, and from a qualitative survey conducted to assess information sources and concerns. Crude and adjusted odds ratios (OR) for noncompliance were calculated. Differences in the proportions of information sources and concerns were compared between compliant and noncompliant patients. A total of 512 patients were included. About 18% (n = 99) of patients were reported to be noncompliant to drug treatment and two-thirds (n = 353) were information seekers. The OR for noncompliance among information seekers was 2.44 (95%CI: 1.34-4.41) after adjustment for confounders and major risk factors. General practitioners were 15.2% more often consulted (p = 0.019) among compliant patients, as were books and television (+13.1%; p = 0.048), whereas no difference in proportions was observed for sources such as internet or gastroenterologists. Information on tips for disease management were 14.2% more often sought among noncompliant patients (p = 0.028). No difference was observed for concerns on research and development on IBD or therapies. In Switzerland, IBD patients noncompliant to treatment were more often seeking disease-related information than compliant patients. Daily management of symptoms and disease seemed to be an important concern of those patients.

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

The Limpopo Non-Metropolitan Drinking Water Supplier Response to a Diagnostic Tool for Technical Compliance.

Science.gov (United States)

Nefale, Avhashoni D; Kamika, Ilunga; Obi, Chikwelu L; Momba, Maggy Nb

2017-07-19

Water services providers should supply water that is fit for human consumption, taking into account multi-barrier approaches and technical aspects such as design aspects, operation monitoring, final water quality compliance monitoring, plant monitoring practices, maintenance, and risk management practices. Against this background, this study focused on applying the diagnostic tool for technical compliance as well as assessing the compliance of water treatment plants with management norms. Six plants in the Vhembe District Municipality were selected; the Vondo, Malamulele, Mutshedzi, and Mutale plants (conventional), and the Dzingahe and Tshedza package plants. During the first assessment, four (Malamulele, Mutshedzi, Mutale and Dzingahe) plants scored between 44% and 49% and achieved Class 3 certification, revealing serious challenges requiring immediate intervention. Two water plants (Vondo and Tshedza, scoring 53% and 63%, respectively) were in the Class 2 category, revealing serious challenges requiring attention and improvement. During the second assessment, all plants scored between 63% and 87% (Class 2 category). The greatest improvement (30%) was noted for the Dzingahe and Tshedza plants, followed by the Malamulele plant, while the Mutale, Vondo, and Mutshedzi plants improved their scores by 20%, 17% and 14%, respectively. After corrective actions and re-measurement, no plant complied. It is recommended that Water Services Providers (WSPs) regularly apply the diagnostic tools and water safety plans as developed in order to comply with applicable standards.

The Limpopo Non-Metropolitan Drinking Water Supplier Response to a Diagnostic Tool for Technical Compliance

Directory of Open Access Journals (Sweden)

Avhashoni D. Nefale

2017-07-01

Full Text Available Water services providers should supply water that is fit for human consumption, taking into account multi-barrier approaches and technical aspects such as design aspects, operation monitoring, final water quality compliance monitoring, plant monitoring practices, maintenance, and risk management practices. Against this background, this study focused on applying the diagnostic tool for technical compliance as well as assessing the compliance of water treatment plants with management norms. Six plants in the Vhembe District Municipality were selected; the Vondo, Malamulele, Mutshedzi, and Mutale plants (conventional, and the Dzingahe and Tshedza package plants. During the first assessment, four (Malamulele, Mutshedzi, Mutale and Dzingahe plants scored between 44% and 49% and achieved Class 3 certification, revealing serious challenges requiring immediate intervention. Two water plants (Vondo and Tshedza, scoring 53% and 63%, respectively were in the Class 2 category, revealing serious challenges requiring attention and improvement. During the second assessment, all plants scored between 63% and 87% (Class 2 category. The greatest improvement (30% was noted for the Dzingahe and Tshedza plants, followed by the Malamulele plant, while the Mutale, Vondo, and Mutshedzi plants improved their scores by 20%, 17% and 14%, respectively. After corrective actions and re-measurement, no plant complied. It is recommended that Water Services Providers (WSPs regularly apply the diagnostic tools and water safety plans as developed in order to comply with applicable standards.

Compliance of zinc supplementation by care givers of children suffering from diarrhea

Directory of Open Access Journals (Sweden)

Smita S Valekar

2014-12-01

Full Text Available Background: Over 2 million children die as a result of diarrhea and dehydration every year. A new ORS formula and introduction of Zinc supplementation offers much improved outcomes for the treatment of childhood diarrhea. Aims: To assess the compliance of Zinc supplementation by caregivers Objectives: 1. To assess the compliance of Zinc supplementation by caregivers, 2. To find out the reason for non-compliance 3. To study the association of socio-demographic variables and non-compliance of children suffering from diarrhea Materials & Method:  Study Design: Cross-sectional survey Study Period: from 1st Sept. 2014 to 31st Oct. 2014 Study Area: Pediatric Outpatient department of Tertiary Care Hospital Inclusion Criteria: Under five children suffering from diarrhea attending Pediatric OPD Study Tool: Questionnaire was administered to care givers and follow up was done on 3rd, 7th & 14th day of Zinc supplementation. Result: 84% of non-compliance was seen in this study. Conclusion: The compliance of Zinc supplementation is poor among caretakers of children suffering from diarrhea.

Effectiveness of the GAEC standard of cross compliance Prohibition of performing unauthorized land levelling on soil erosion control

Directory of Open Access Journals (Sweden)

Paolo Bazzoffi

2011-08-01

Full Text Available The GAEC standard land levelling under authorization of cross compliance prohibits farmers from levelling land through bulldozing without a specific permission issued by the proper territorial authority. The aim of the standard is to ensure the protection of soil from accelerated erosion that almost always occurs when land is levelled without conservative criteria. Land levelling prior to planting or replanting specialized crops, especially orchards, is indicated by agronomists as essential to the full mechanization of cultivation and harvesting operations and the success of economic investment. Land levelling leads to a deep modification of the hill slopes, so it may produce serious damage to the environment if carried out in the absence of a carefully planned design. In other words, a design that takes the aspects of soil conservation into account, especially for steep hill slopes where the insite and offsite environmental impacts of soil erosion may be more pronounced. With regard to the areas involved, land levelling plays a key role on a national scale, one only needs to think of the vineyards planted on the country’s hill slopes, which in 1970 covered an area of 793,000 hectares. Moreover, despite the continued reduction in areas planted with vines, from 1990 to 2002 the area devoted to DOC and DOCG wines increased by about 29% and the average size of vineyards has also increased. This is a clear sign of the current trend, with the transition from the family model to the industrial model of orchard management, with extensive use of machinery and thus the use of bulldozers for levelling. The authorization topic, on which the standard of compliance is based, is analysed in detail. In summary we can say that, according to law, the permit required by the GAEC standard is currently mandatory only for those areas subject to the Hydrogeological constraint (Royal decree 30 December 1923 No. 3267 and for parks or other areas for which the

Towards an international address standard

CSIR Research Space (South Africa)

Coetzee, S

2008-02-01

Full Text Available in a better user experience. Standards compliance allows for the separation of concerns: HTML for content, Cascading Style Sheets (CSS) for presentation and JavaScript for dynamic behaviour. Standards compliant documents are also...) and cascading style sheets through CSS (CSS n.d.), whilst the JavaScript specification has been standardised by Ecma International (another standards organisation for information and communication systems), in the form of EcmaScript (Ecma...

Oil Mist Compliance

Energy Technology Data Exchange (ETDEWEB)

Lazarus, Lloyd

2009-02-02

This report summarizes activities at the KCP related to evaluating and modifying machine tools in order to be in compliance with Section 23 of DOE 10 CFR 851, Worker Safety and Health Program. Section 851.23 (a) states that “Contractors must comply with the following safety and health standards that are applicable to the hazards in their covered workplace”, and subsection 9 contains the following applicable standard: “American Congress of Governmental Industrial Hygienists (ACGIH), ‘Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices,’ (2005) (incorporated by reference, see §851.27) when the ACGIH Threshold Limit Values are lower (more protective) than permissible exposure limits in 29 CFR 1910.” In the 2005 ACGIH – Threshold Limit Value book a Notice of Change was issued for exposure to mineral oil mist used in metalworking fluids (MWFs). The effects of planning for the new facility and which machine tools would be making the transition to the new facility affected which machine tools were modified.

METHODOLOGY COMPARATIVE EVALUATION OF PROFESSIONAL STANDARDS AND EDUCATION STANDARDS WITH THE USE OF NON-NUMERIC DATA PROCESSING METHODS

Directory of Open Access Journals (Sweden)

Gennady V. Abramov

2016-01-01

Full Text Available The article discusses the development of a technique that allows for a comparative assessment of the requirements of the professional standard and the federal state educational standards. The results can be used by universities to adjust the learning process for the analysis of their curricula to better compliance with professional standards. 

Compliance with minimum information guidelines in public metabolomics repositories.

Science.gov (United States)

Spicer, Rachel A; Salek, Reza; Steinbeck, Christoph

2017-09-26

The Metabolomics Standards Initiative (MSI) guidelines were first published in 2007. These guidelines provided reporting standards for all stages of metabolomics analysis: experimental design, biological context, chemical analysis and data processing. Since 2012, a series of public metabolomics databases and repositories, which accept the deposition of metabolomic datasets, have arisen. In this study, the compliance of 399 public data sets, from four major metabolomics data repositories, to the biological context MSI reporting standards was evaluated. None of the reporting standards were complied with in every publicly available study, although adherence rates varied greatly, from 0 to 97%. The plant minimum reporting standards were the most complied with and the microbial and in vitro were the least. Our results indicate the need for reassessment and revision of the existing MSI reporting standards.

77 FR 53884 - Automatic Underfrequency Load Shedding and Load Shedding Plans Reliability Standards; Notice of...

Science.gov (United States)

2012-09-04

... Underfrequency Load Shedding and Load Shedding Plans Reliability Standards; Notice of Compliance Filing Take notice that on August 9, 2012, North American Electric Reliability Corporation submitted a compliance... Load Shedding Plans Reliability Standards, 139 FERC ] 61,098, (Order No. 763) (2012). Any person...

The Impact of Social Norms, Trust, and Fairness on Voluntary Tax Compliance in Austria

Directory of Open Access Journals (Sweden)

Maria Kostritsa

2017-12-01

Full Text Available Existing literature stresses the importance of economic factors when aiming to increase voluntary tax compliance. However, emerging voices also point out to relevant social factors, but emphasize that more research needs to be carried out for their verification. Therefore, in this article, research was conducted to provide further evidence to show how social factors have an influence on voluntary tax compliance. The research is the first attempt to replicate the results of the structural model of Jimenez and Iyer (2016 outside of the us, claiming that one’s moral standards (personal norms and perceived fairness directly influence voluntary tax compliance, meanwhile social norms and trust in government have an indirect impact on tax compliance via influencing personal norms and perceived fairness. To achieve a beneficial result, 333 Austrian taxpayers were surveyed in Austria. The data was analysed in spss using frequencies, correlations and regression analysis. The results verify the aforementioned assumptions and emphasize its consideration when aiming to increase voluntary tax compliance.

Interventions to promote psychiatric patients' compliance to mental ...

African Journals Online (AJOL)

Method: A systematic review was chosen as a design to identify primary studies that answered the following research question: What is the current evidence on interventions to promote psychiatric patients' compliance to mental health treatment? Selected electronic databases were thoroughly searched. Studies were ...

Evaluation of China's local enforcement of energy efficiency standards and labeling programs for appliances and equipment

International Nuclear Information System (INIS)

Khanna, Nina Zheng; Zhou, Nan; Fridley, David; Fino-Chen, Cecilia

2013-01-01

Aims: This paper aims to evaluate local enforcement of China's mandatory appliance and equipment energy efficiency standards and labeling programs, two increasingly important policies for meeting national energy and carbon reduction targets. The expected energy savings of efficiency standards and labels can be fully realized only with strong enforcement to ensure compliance for all products sold. This paper provides comprehensive retrospective evaluation of the methodologies, results, progress and remaining challenges in pilot enforcement projects initiated in the absence of consistent national check-testing focused on energy efficiency. Scope: This paper's scope is focused on 2006–2009 pilot local check-tests conducted to verify appliance and equipment compliance with China's mandatory energy label and efficiency standards. Conclusions: This paper finds both improvement and some backsliding in compliance rates over time. Compared to earlier efforts, 2009 check-tests covered a wider regional and product scope but demonstrated greater variation in compliance rates. Labeling display and energy efficiency compliance was generally high across regions and most products, but lower compliance rates were observed in less economically developed regions and for lighting and industrial products. Based on these findings, areas for improvement in local awareness, product sampling methodology, check-testing tools and procedures are identified. - Highlights: • China's mandatory standards and labeling crucial to national energy saving goals. • China's 2006–2009 pilot efficiency check-testing for standards and labeling evaluated. • Wider geographic and product scope in 2009, but greater variation in compliance. • Generally high compliance, but lower rates for less economically developed region. • Local check-test capacity improving but methodological challenges remain

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…

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

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.

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.

Therapist empathy, homework compliance, and outcome in cognitive behavioral therapy for generalized anxiety disorder: partitioning within- and between-therapist effects.

Science.gov (United States)

Hara, Kimberley M; Aviram, Adi; Constantino, Michael J; Westra, Henny A; Antony, Martin M

2017-09-01

Although client-perceived therapist empathy relates to positive therapy outcomes, including in cognitive behavioral therapy (CBT), little is known about how empathy exerts its ameliorative effect. One possible way is by promoting clients' subsequent homework compliance, a variable that also predicts positive outcomes in CBT. The present study sought to investigate simultaneously, in the context of 43 therapist-client dyads receiving 15 sessions of CBT for generalized anxiety disorder, (1) the association of early client-perceived therapist empathy (averaged over sessions 1, 3, 5) with mid-treatment client homework compliance (averaged over sessions 6, 8, 10); (2) the association of mid-treatment homework compliance on client posttreatment worry severity; and (3) the indirect effect of early perceived therapist empathy on posttreatment worry through mid-treatment homework compliance. Given that clients were nested within therapists, we examined both within- and between-therapist differences in clients' ratings of therapist empathy and homework compliance, and tested both of these indices as predictors of the relevant dependent variables in a multilevel model. At the within-therapist level (i.e., differences between clients within a given therapist's caseload), greater early empathy was associated with greater mid-treatment homework compliance. At the between-therapist level (i.e., differences between therapists across all of their cases), greater between-therapist homework compliance was related to lower posttreatment worry. Finally, homework compliance was not found to mediate the relationship between empathy and posttreatment outcome. The results underscore the importance of parsing client and therapist effects, and are discussed with regard to their training and research implications.

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

49 CFR Appendix A to Part 533 - Example of Calculating Compliance Under § 533.5 Paragraph (g)

Science.gov (United States)

2010-10-01

... 49 Transportation 6 2010-10-01 2010-10-01 false Example of Calculating Compliance Under § 533.5 Paragraph (g) A Appendix A to Part 533 Transportation Other Regulations Relating to Transportation... ECONOMY STANDARDS Pt. 533, App. A Appendix A to Part 533—Example of Calculating Compliance Under § 533.5...

The role of the compliance officer – a comparison of US, UK and German law and practice.

OpenAIRE

Kanzenbach, Katrin

2017-01-01

The thesis introduces the role of the corporate compliance officer under US, UK and German law and practice. The aim of the thesis is to analyze the compliance function within private sector companies in the three selected jurisdictions in order to establish a model of the German compliance officer. My research is intended to bridge the gap in knowledge concerning the applicable legal standards required to ensure the effectiveness of this position. There is a lack of uniformity and standardiz...

40 CFR Table 38 to Subpart Uuu of... - Initial Compliance With Work Practice Standards for HAP Emissions From Bypass Lines

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Initial Compliance With Work Practice... Pollutants for Petroleum Refineries: Catalytic Cracking Units, Catalytic Reforming Units, and Sulfur Recovery Units Pt. 63, Subpt. UUU, Table 38 Table 38 to Subpart UUU of Part 63—Initial Compliance With Work...

Standardized Treatment of Neonatal Status Epilepticus Improves Outcome.

Science.gov (United States)

Harris, Mandy L; Malloy, Katherine M; Lawson, Sheena N; Rose, Rebecca S; Buss, William F; Mietzsch, Ulrike

2016-12-01

We aimed to decrease practice variation in treatment of neonatal status epilepticus by implementing a standardized protocol. Our primary goal was to achieve 80% adherence to the algorithm within 12 months. Secondary outcome measures included serum phenobarbital concentrations, number of patients progressing from seizures to status epilepticus, and length of hospital stay. Data collection occurred for 6 months prior and 12 months following protocol implementation. Adherence of 80% within 12 months was partially achieved in patients diagnosed in our hospital; in pretreated patients, adherence was not achieved. Maximum phenobarbital concentrations were decreased (56.8 vs 41.0 µg/mL), fewer patients progressed from seizures to status epilepticus (46% vs 36%), and hospital length of stay decreased by 9.7 days in survivors. In conclusion, standardized, protocol-driven treatment of neonatal status epilepticus improves consistency and short-term outcome. © The Author(s) 2016.

The iPod binocular home-based treatment for amblyopia in adults: efficacy and compliance.

Science.gov (United States)

Hess, Robert F; Babu, Raiju Jacob; Clavagnier, Simon; Black, Joanna; Bobier, William; Thompson, Benjamin

2014-09-01

Occlusion therapy for amblyopia is predicated on the idea that amblyopia is primarily a disorder of monocular vision; however, there is growing evidence that patients with amblyopia have a structurally intact binocular visual system that is rendered functionally monocular due to suppression. Furthermore, we have found that a dichoptic treatment intervention designed to directly target suppression can result in clinically significant improvement in both binocular and monocular visual function in adult patients with amblyopia. The fact that monocular improvement occurs in the absence of any fellow eye occlusion suggests that amblyopia is, in part, due to chronic suppression. Previously the treatment has been administered as a psychophysical task and more recently as a video game that can be played on video goggles or an iPod device equipped with a lenticular screen. The aim of this case-series study of 14 amblyopes (six strabismics, six anisometropes and two mixed) ages 13 to 50 years was to investigate: 1. whether the portable video game treatment is suitable for at-home use and 2. whether an anaglyphic version of the iPod-based video game, which is more convenient for at-home use, has comparable effects to the lenticular version. The dichoptic video game treatment was conducted at home and visual functions assessed before and after treatment. We found that at-home use for 10 to 30 hours restored simultaneous binocular perception in 13 of 14 cases along with significant improvements in acuity (0.11 ± 0.08 logMAR) and stereopsis (0.6 ± 0.5 log units). Furthermore, the anaglyph and lenticular platforms were equally effective. In addition, the iPod devices were able to record a complete and accurate picture of treatment compliance. The home-based dichoptic iPod approach represents a viable treatment for adults with amblyopia. © 2014 The Authors. Clinical and Experimental Optometry © 2014 Optometrists Association Australia.

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.

Effect of beta-adrenergic blockade on elevated arterial compliance and low systemic vascular resistance in cirrhosis

DEFF Research Database (Denmark)

Møller, Søren; Bendtsen, Flemming; Henriksen, Jens Henrik

2001-01-01

with beta-blockers, but the effect of this treatment on arterial compliance has not been investigated. The aim of the present study was therefore to assess the effects of propranolol on the arterial compliance of patients with cirrhosis. METHODS: Twenty patients with cirrhosis underwent a haemodynamic......) of 17.8 mmHg, and responded to beta-blocker treatment with a significant reduction in the HVPG (-16%; P beta-adrenergic blockade (1.27 versus 1.29 ml/mmHg, +2%, ns), whereas...... with beta-blockers increases small vessel (arteriolar) vascular tone towards the normal level, but does not affect the elevated compliance of the larger arteries in patients with cirrhosis....

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.

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.

[Depression, social support and compliance in patients with chronic heart failure].

Science.gov (United States)

Reutlinger, Julia; Müller-Tasch, Thomas; Schellberg, Dieter; Frankenstein, Lutz; Zugck, Christian; Herzog, Wolfgang; Lossnitzer, Nicole

2010-01-01

Depressive patients with chronic heart failure (CHF) show less social integration and greater physical impairment as well as poorer compliance than non depressive CHF patients. Using multiple regression analyses, this study (n=84) investigated a potential mediating effect of depression on the relationship between compliance and both social support and physical functioning. Results did not support the hypothesized mediating effect of depression. However, the variables age, depression, left ventricular ejection fraction (LVEF) and social support were associated with self-reported compliance. Therefore, a lack of social support and depression should be considered as possible reasons, if patients are noncompliant during the treatment process. © Georg Thieme Verlag KG Stuttgart · New York.

Core labour standards and exports

OpenAIRE

Siroën, Jean-Marc

2017-01-01

(english) Core labour standards defined by the ILO in 1998 are universal, but applied very differently across countries. Compliance is much higher in high income countries. However, the causality between improved labour standards and economic growth remains a controversial issue. Export-led growth strategies might encourage developing countries to curb the process of standards improvement. In this way, they can raise the volume of their unskilled labour endowments (child and/or forced labour)...

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.

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....