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Compliance
Kinds of Compliance Terms modified by Compliance Selected AbstractsARSENIC IN THE SHALLOW GROUND WATERS OF CONTERMINOUS UNITED STATES: ASSESSMENT, HEALTH RISKS, AND COSTS FOR MCL COMPLIANCE,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 2 2006Navin Kumar C. Twarakavi ABSTRACT: A methodology consisting of ordinal logistic regression (OLR) is used to predict the probability of occurrence of arsenic concentrations in different threshold limits in shallow ground waters of the conterminous United States (CONUS) subject to a set of influencing variables. The analysis considered a number of maximum contaminant level (MCL) options as threshold values to estimate the probabilities of occurrence of arsenic in ranges defined by a given MCL of 3, 5, 10, 20, and 50 ,g/l and a detection limit of 1 ,g/l. The fit between the observed and predicted probability of occurrence was around 83 percent for all MCL options. The estimated probabilities were used to estimate the median background concentration of arsenic in the CONUS. The shallow ground water of the western United States is more vulnerable than the eastern United States. Arizona, Utah, Nevada, and California in particular are hotspots for arsenic contamination. The risk assessment showed that counties in southern California, Arizona, Florida, and Washington and a few others scattered throughout the CONUS face a high risk from arsenic exposure through untreated ground water consumption. A simple cost effectiveness analysis was performed to understand the household costs for MCL compliance in using arsenic contaminated ground water. The results showed that the current MCL of 10 ,g/l is a good compromise based on existing treatment technologies. [source] Compliance in small claims court: Exploring the factors associated with defendants' level of compliance with mediated and adjudicated outcomesCONFLICT RESOLUTION QUARTERLY, Issue 2 2003Jennie J. Long This study explores how defendants in small claims cases, settled in either mediation or adjudication, react to case outcomes that require them to make some form of payment to the opposing party. Of particular interest was the relationship between dispute resolution forum and the reasons given for compliant behavior. Data were drawn from thirty-nine structured interviews in small claims cases filed in a local justice court. In mediated cases, defendants tended to comply with case outcomes from a sense of personal responsibility and obligation to fulfill a promise made to complainants, while defendants in adjudicated cases reported that they complied with the judgment in their case because of their duty to obey the law. [source] Patterns of Compliance with the German Corporate Governance CodeCORPORATE GOVERNANCE, Issue 4 2008Till Talaulicar ABSTRACT Manuscript Type: Empirical Research Question/Issue: This study investigates whether the form of compliance with the recommendations of the German Corporate Governance Code (GCGC) appears to be idiosyncratic to a specific company or features similarities across firms. The major aim of this research is thus to explore the ability of a classification of compliance patterns to account for the similarities and differences between firms regarding their conformity with the GCGC. Research Findings/Insights: Based on seven dimensions of code compliance, cluster analysis is used to identify discrete groups of companies with similar patterns of code observance. We determine eight patterns of compliance which are characterized by distinct forms of code conformity. Theoretical Academic Implications: The identified cluster solution does not merely reflect the number of rejected code recommendations. Rather, companies with very similar rates of overall compliance with the GCGC are assigned to different clusters because they feature, at the same time, different patterns of code conformity. These findings imply that governance prediction and governance performance studies have to overcome overly aggregated measures of code compliance which only incorporate the number of rejected code recommendations. Practitioner/Policy Implications: This study provides evidence to practitioners and policy makers that firms can be classified regarding their compliance with the code recommendations. In-depth analyses of the identified patterns of compliance furthermore reveal that some patterns may indicate less well substantiated deviations from the code and partly even decouplings of the declared compliance practices. [source] Sarbanes Oxley Section 404 Costs of Compliance: a case studyCORPORATE GOVERNANCE, Issue 2 2007Lineke Sneller In 2002 US Congress approved the Sarbanes Oxley Act (SOX). Section 404 requires companies to assess their internal controls and acquire an attestation of this assessment from their external auditor. In this paper, we investigate the costs of compliance of this assessment and attestation. The European division of a US listed company is used as a case study. The divisional project approach is described, and costs of compliance for this division are presented in two categories: assessment costs, mainly hours spent by internal staff; and attestation costs, mainly audit fees. The case study shows that the internal hours spent on assessment are approximately 12 times higher than the initial estimate made by the SEC in 2002, and that the realised other expenses are approximately 1.4 times higher than this estimate. Furthermore, a year on year increase of 50 per cent of the company's audit fee in the first year of Section 404 compliance is found. Companies can reduce the costs of compliance by implementing programmed controls, using auditors from countries with lower rates, remediating material weaknesses only, focusing on the internal control system rather than on individual controls, and by encouraging the auditor to rely on the company's assessment. [source] Predictors of glycaemic control in indigent patients presenting with diabetic ketoacidosisDIABETES OBESITY & METABOLISM, Issue 3 2005M. Maldonado Aim:, To derive predictors of good glycaemic control in patients presenting with diabetic ketoacidosis (DKA) followed prospectively in a specialized clinic. Methods:, One hundred and sixty-one adult patients were admitted during a 31-month period and followed for at least 12 months. After 1 year, the patients were classified into three groups: good control (GC) (HbA1c , 7%), intermediate control (IC) (HbA1c 7,9%) and poor control (PC) (HbA1c > 9%). Characteristics of patients in the three groups were compared both at baseline and during follow-up. Results:, At 12 months, 36% of the patients were classified as GC, 27% as IC and 37% as PC. GC patients had higher fasting serum C-peptide levels 0.7 ± 0.54 compared to 0.38 ± 0.29 and 0.16 ± 0.21 nmol/l, respectively, for the IC and PC patients (p < 0.0001). A higher proportion GC patient had a C-peptide level greater than 0.33 nmol/l than that for IC and PC patients (86, 61 and 19%, respectively; p < 0.0001). Exogenous insulin was safely discontinued in 50, 30 and 3% of patients, respectively, in the GC, IC and PC groups (p < 0.0001). Compliance with life-style interventions was higher in the GC than that in IC and PC patients (87, 41 and 5%, respectively; p < 0.0001). In the logistic regression analysis, predictors of good glycaemic control were having baseline fasting serum C-peptide value ,0.33 mmol/l, OR: 3.01 (95% CI 1.07,8.55, p = 0.03) and compliance with life-style interventions OR 12.66 (95% CI 3.73,51.57, p = 0.0001). Conclusion:, Among adult patients with DKA, significant predictors of good glycaemic control are preserved ,-cell function and compliance with life-style modifications. [source] Assessment of Carotid Compliance Using Real Time Vascular Ultrasound Image Analysis in Marfan SyndromeECHOCARDIOGRAPHY, Issue 4 2009Anatoli Kiotsekoglou M.D. Background: Fibrillin-1 deficiency, dysregulated cytokine transforming growth factor-,, and increased collagen deposition related to fibrillin-1 gene mutations could predispose to impaired carotid compliance (CC) in Marfan syndrome (MFS). We sought to detect any alterations in CC using the vascular image analysis system (VIA). Methods and Results: Thirty-two MFS patients, 20 men and 12 women (mean age 34.2 ± 12.05 years), and 29 controls matched for age, sex, and body surface area (BSA) were recruited. The entire length of each carotid system was initially scanned longitudinally using a 14 MHz linear transducer. Then, a stereotactic clamp held the transducer in contact with the carotid artery. Arterial diameter changes during the cardiac cycle were recorded for 1 minute from both right (RCCA) and left common carotid arteries (LCCA) separately using the VIA system. RCCA and LCCA compliance and distensibility measurements were significantly reduced in MFS patients when compared to controls, P < 0.05. RCCA and LCCA intima-media thickness did not differ between patients and controls, P > 0.05. MFS diagnosis and age were associated with reduced CC in both carotid arteries after adjusting for variables such as, sex, BSA, heart rate, beta-blockade, intima-media thickness, and aortic root size. Conclusions: Our findings showed a reduction in CC in adult patients with MFS. This could be attributed to fibrillin-1 deficiency resulting in structural abnormalities in the carotid arterial wall. [source] Assessment of Elastic Properties of the Descending Thoracic Aorta By Transesophageal Echocardiography with Acoustic Quantification in Patients with a StrokeECHOCARDIOGRAPHY, Issue 8 2000Seok-Min Kang M.D. Previous studies have described the use of transesophageal echocardiography (TEE) with acoustic quantification (AQ) in assessing aortic elastic properties. We hypothesized that patients with a prior history of stroke (ST) may have a higher risk of atherosclerotic change in great vessels compared to nonstroke subjects (NST) and thus have decreased elastic properties. We assessed the elastic properties of the descending thoracic aorta (DTA) by TEE in ST patients and compared them with data in NST patients. Subjects included 31 with ST without any evidence of emboli originating from the heart (age 51 ± 10 years, M: F = 20: 11) and 25 age-matched NST (M: F= 8: 17). Patients with significant valvular heart disease including aortic and mitral regurgitation, left ventricular dysfunction (ejection fraction < 55%), and congenital heart disease were excluded. Compliance (C), distensibility (D), and stiffness index (SI) were measured using AQ and M-mode measurement at a level of the left atrium. We scored atherosclerotic risk factors (ARF) such as a history of diabetes, hypertension, smoking, hypercholesterolemia, and the presence of atheroma of DTA. There was no evidence of atheroma of DTA in NST. There were no significant differences in heart rate and systolic and diastolic blood pressure between ST and NST patients. Fractional area change (FAC) of DTA was significantly lower in ST than in NST patients (3.2 ± 1.6 vs 5.4 ± 2.5%, P= 0.000). ST patients had significantly lower C (1.2 ± 0.4 vs 1.5 ± 0.7 times 10 -3 cm2 mmHg -1, P= 0.039), lower D (0.8 ± 0.3 vs 1.5 ± 0.8 times 10 -3 mmHg -1, P= 0.000), and higher SI (10.3 ± 8.8 vs 5.3 ± 2.9, P= 0.006) than NST patients. ST patients without atheroma of DTA (n± 21) also had significantly lower C (1.1 ± 0.4 vs 1.5 ±0.7 times 10 -3 cm -2 mmHg -1, P= 0.038) and lower D (3.5 ± 1.4 vs 4.8 ± 2.4 times 10 -3 mmHg -1, P= 0.021) than NST patients. There was a significant positive correlation between SI and the score of ARF (r= 0.51, P= 0.000). The regional elastic properties of DTA measured by TEE with AQ and M-mode method were abnormal in ST. Therefore, TEE with AQ technique may have a possible clinical application for the detection of early atherosclerotic changes such as alteration of elastic properties in morphological normal DTA. [source] The Russian ,flat tax' reformECONOMIC POLICY, Issue 43 2005Anna Ivanova SUMMARY Russian's ,flat tax' In 2001, Russia dramatically reduced its higher rates of personal income tax (PIT), establishing a single marginal rate at the low level of 13%. In the following year, real revenue from the PIT increased by about 26%. This ,flat tax' experience has attracted much attention (and emulation), making it perhaps the most important tax reform of recent years. But it has been little studied. This paper asks whether the strong performance of PIT revenue was itself a consequence of this reform, using both macro evidence and, in particular, micro level data on the experiences of individuals and households affected by the reform to varying degrees. It concludes that there is no evidence of a strong supply side effect of the reform. Compliance, however, does appear to have improved quite substantially , by about one third, according to our estimates , though it remains unclear whether this was due to the parametric tax reform or to accompanying changes in enforcement. , Anna Ivanova, Michael Keen and Alexander Klemm [source] The Current Usage of Selectivity Coefficients for the Characterization of Ion-Selective Electrodes.ELECTROANALYSIS, Issue 12 2003A Critical Survey of the 2000/2001 Literature Abstract The articles describing new ion-selective electrodes published during the years 2000/2001 in eight leading analytical chemistry journals have been surveyed. Compliance with the IUPAC recommendations of the procedures used for characterizing the selectivity of the new electrodes has been checked. It was found that the information accompanying the selectivity data obtained according to the procedures recommended by IUPAC or their variations was frequently insufficient for interpreting of the electrode behavior and comparing with other sets of data, thus reducing the significance of the values provided. Some criteria for improving the communication between researchers in the field are suggested. [source] Optimization of activated carbon-based decontamination of fish oil by response surface methodologyEUROPEAN JOURNAL OF LIPID SCIENCE AND TECHNOLOGY, Issue 7 2007Åge Oterhals Abstract The effect of activated carbon (AC) adsorption on the reduction of persistent organic pollutants (POP) in fish oil was studied based on response surface methodology at a 5-g/kg AC inclusion level. Pretreatment of the oil by alkali refining and bleaching increased the POP levels. The tested process variables (contact time and temperature) affected the AC adsorption rate and significant first- and second-order response models could be established. Polychlorinated dibenzo- p -dioxins and dibenzofurans (PCDD/F) showed a very rapid adsorption behavior and the concentration and toxic equivalent (TEQ) level could be reduced by 99%. Adsorption of dioxin-like polychlorinated biphenyls (DL-PCB) was less effective and depended on ortho substitution, i.e. non- ortho PCB were adsorbed more effectively than mono- ortho PCB with a maximum of 87 and 21% reduction, respectively, corresponding to a DL-PCB-TEQ reduction of 73%. A common optimum for both PCDD/F and DL-PCB adsorption could not be identified. AC treatment had no effect on the level of polybrominated diphenyl ether flame retardants. The differences in adsorption patterns may be explained based on molecular conformation. No change in oil quality could be observed based on oxidation parameters. Compliance with present PCDD/F and DL-PCB legislation levels in fish oil can be achieved based on AC adsorption. [source] Compliance and personality: the vulnerability of the unstable introvertEUROPEAN JOURNAL OF PERSONALITY, Issue 5 2004Gisli H. Gudjonsson The aim of the study was to assess the relationship of compliance with Eysenck's three personality dimensions: psychoticism, extraversion, and neuroticism. Three groups of participants (prison inmates, college students, and university students) completed the Gudjonsson Compliance Scale (GCS) and the Eysenck Personality Questionnaire (EPQ). As predicted, compliance correlated positively with neuroticism and negatively with extraversion in all groups, whereas for psychoticism the correlation was positive among the prison inmates, negative for college students, and non-significant for university students. A quadrant analysis according to Eysenck's original two-dimensional framework (neuroticism,stability and introversion,extraversion) showed that compliance was highest among unstable introverts and lowest among stable extraverts. The findings are discussed in relation to recent work on person-type approaches. Copyright © 2004 John Wiley & Sons, Ltd. [source] Effect of Mounting Material Compliance on Nanoindentation Response of Metallic Materials,ADVANCED ENGINEERING MATERIALS, Issue 1-2 2009Grant A. Crawford Nanoindentation is an important and versatile technique for probing the properties of materials on the nanoscale. There are many factors that may affect nanoindentation measurements. One factor is the added compliance associated with mounting resins used to fix nanoindentation samples in place. We report on the effect of specimen mounting resin compliance on nanoindentation results. [source] Assessment of salmon stocks and the use of management targets; a case study of the River Tamar, EnglandFISHERIES MANAGEMENT & ECOLOGY, Issue 1 2007K. HENDRY Abstract, Over recent years the rod and net catch of Atlantic salmon, Salmo salar L., on the River Tamar in south-west England has decreased markedly, resulting in a consistent failure to meet the minimum egg deposition target (conservation limit). Compliance with the target is by annual assessment using rod catch as the major input variable. Further analysis suggested a disproportionate deterioration in the rod fishery performance of the Tamar compared with rivers locally, regionally and nationally. A concomitant decrease in rod licence sales and fishing effort, above both national and regional trends was also evident. However, examination of juvenile electric fishing and adult fish counter data revealed a different trend for the past 10 years, indicating a stable fish population, albeit at a lower level of abundance than previously. The analyses suggested that without consideration of changes in effort and rod exploitation rate, rod catch alone is not a reliable indicator of stock abundance and hence should not be used as such in stock assessment. [source] Behavioral Facilitation of Medical Treatment for Headache,Part II: Theoretical Models and Behavioral Strategies for Improving AdherenceHEADACHE, Issue 9 2006Jeanetta C. Rains PhD This is the second of 2 articles addressing the problem of noncompliance in medical practice and, more specifically, compliance with headache treatment. The companion paper describes the problem of noncompliance in medical practice and reviews literature addressing compliance in headache care (Behavioral Facilitation of Medical Treatment for Headache,Part I: Review of Headache Treatment Compliance). The present paper first summarizes relevant health behavior theory to help account for the myriad biopsychosocial determinants of adherence, as well as patient's shifting responsiveness or "readiness for change" over time. Appreciation of health behavior models may assist in optimally tailoring interventions to patient needs through instructional, motivational, and behavioral treatment strategies. A wide range of specific cognitive and behavioral compliance-enhancing interventions are described, which may facilitate treatment adherence among headache patients. Strategies address patient education, patient/provider interaction, dosing regimens, psychiatric comorbidities, self-efficacy enhancement, and other behavioral interventions. [source] Failure of Helicobacter pylori Treatment After Regimes Containing Clarithromycin: New Practical Therapeutic OptionsHELICOBACTER, Issue 6 2008Bruno Sanches Abstract Failure of Helicobacter pylori treatment is a growing problem in daily practice. Aim:, To evaluate the efficacy of two new regimes as second-line options in a randomized and prospective study. Methods:, Patients in whom a first eradication regime containing clarithromycin had failed were included. After performing gastroscopy and a 13C-urea breath test (UBT), the patients were randomized to receive a combination of 20 mg of rabeprazole, 500 mg of levofloxacin, and 200 mg (two tablets) of furazolidone administered once daily for 10 days (RLF) or the combination of 20 mg of rabeprazole, 120 mg (two tablets) of bismuth subcitrate, 100 mg of doxycycline, and 200 mg of furazolidone, administered twice daily for 10 days (RBDF). Clinical examinations and new UBT were performed 60 days after therapy. Results:, Sixty patients were included (mean age, 46 years, 57% females). Two patients were excluded: one because of adverse effects and another as a result of protocol violation. Compliance was similar in both groups (90% took all medications correctly). Side-effects (96% mild) were observed in 87% of the patients and were comparable between groups, except diarrhea, which was more frequent in group RLF (p= .025). Intention-to-treat cure rates were 77% (95% confidence interval (CI): 62,93%) in the RLF group and 83% (95% CI: 68,97%) in the RBDF group (p= .750). Per-protocol cure rates were 80% (95% CI: 65,95%) in the RLF group and 82% (95% CI: 67,96%) in the RBDF group (p= 1.0). Conclusions:, Both once-daily triple (rabeprazole, levofloxacin, and furazolidone) and twice-daily quadruple therapy (rabeprazole, bismuth subcitrate, doxycycline, and furazolidone) for 10 days achieved encouraging results. Subsequent studies should be performed to evaluate antibiotic resistance, doses, dosing intervals, duration of treatment, and safety of these two regimes. [source] ,Rescue' Therapy with Rifabutin after Multiple Helicobacter pylori Treatment FailuresHELICOBACTER, Issue 2 2003Javier P. Gisbert abstract Aim. Eradication therapy with proton pump inhibitor, clarithromycin and amoxicillin is extensively used, although it fails in a considerable number of cases. A ,rescue' therapy with a quadruple combination of omeprazole, bismuth, tetracycline and metronidazole (or ranitidine bismuth citrate with these same antibiotics) has been recommended, but it still fails in approximately 20% of cases. Our aim was to evaluate the efficacy and tolerability of a rifabutin-based regimen in patients with two consecutive H. pylori eradication failures. Patients and Methods. Design: Prospective multicenter study. Patients: Consecutive patients in whom a first eradication trial with omeprazole, clarithromycin and amoxicillin and a second trial with omeprazole, bismuth, tetracycline and metronidazole (three patients) or ranitidine bismuth citrate with these same antibiotics (11 patients) had failed were included. Intervention: A third eradication regimen with rifabutin (150 mg bid), amoxicillin (1 g bid) and omeprazole (20 mg bid) was prescribed for 14 days. All drugs were administered together after breakfast and dinner. Compliance with therapy was determined from the interrogatory and the recovery of empty envelopes of medications. Outcome: H. pylori eradication was defined as a negative 13C-urea breath test 8 weeks after completing therapy. Results. Fourteen patients have been included. Mean age ± SD was 42 ± 11 years, 41% males, peptic ulcer (57%), functional dyspepsia (43%). All patients took all the medications and completed the study protocol. Per-protocol and intention-to-treat eradication was achieved in 11/14 patients (79%; 95% confidence interval = 49,95%). Adverse effects were reported in five patients (36%), and included: abdominal pain (three patients), nausea and vomiting (one patient), and oral candidiasis (one patient); no patient abandoned the treatment due to adverse effects. Conclusion. Rifabutin-based rescue therapy constitutes an encouraging strategy after multiple previous eradication failures with key antibiotics such as amoxicillin, clarithromycin, metronidazole and tetracycline. [source] High Efficacy of Ranitidine Bismuth Citrate, Amoxicillin, Clarithromycin and Metronidazole Twice Daily for Only Five Days in Helicobacter pylori EradicationHELICOBACTER, Issue 2 2001Javier P. Gisbert ABSTRACT Aim. The combination of a proton pump inhibitor (PPI) or ranitidine-bismuth-citrate (Rbc) and two antibiotics for 7,10 days are, at present, the preferred treatments in Helicobacter pylori eradication. However, therapies for fewer than 7 days have been scarcely evaluated and it is unknown whether the length of treatment can be shortened, without a lost of efficacy, if three instead of two antibiotics are used. The aim of our study was to evaluate the efficacy of Rbc plus three antibiotics for only 5 days in H. pylori eradication. Methods. We prospectively studied 80 patients (34% duodenal ulcer, 66% functional dyspepsia) infected by H. pylori. At endoscopy, biopsies were obtained for histological study and rapid urease test, and a 13C-urea breath test was carried out. Urea breath test was repeated 4 weeks after completing eradication treatment with Rbc [400 mg twice a day (bid)], amoxicillin (1 g bid), clarithromycin (500 mg bid) and metronidazole (500 mg bid). All drugs were administered together after breakfast and dinner for 5 days only, and no treatment was administered thereafter. Compliance with therapy was determined from the interrogatory and the recovery of empty envelopes of medications. Results. In 79 out of the 80 patients, H. pylori eradication success or failure was assessed after therapy (one patient was lost from follow-up). All but one of these 79 patients took all the medications (one patient stopped treatment on the day 3 due to nausea/vomiting). Per protocol eradication was achieved in 72/78 (92%; 95% CI, 84,96%) and in 72/80 (90%; 81,95%) by intention-to-treat. Therapy was more effective in patients with duodenal ulcer than in those with functional dyspepsia [100% (87,100%) vs. 85% (73,92%) by intention-to-treat; p < .05]. Adverse effects were described in ten patients (12%), and included the perception of a metallic taste (eight patients), nausea/vomiting (two patients, one of them abandoned the treatment due to this), and diarrhea (two patients). Conclusion. The combination of Rbc, amoxicillin, clarithromycin and metronidazole for only 5 days represents a promising therapy for H. pylori infection, due to its high efficacy, simple posology, low cost and excellent tolerance. [source] How reliable is an undetectable viral load?HIV MEDICINE, Issue 8 2009C Combescure Objectives An article by the Swiss AIDS Commission states that patients with stably suppressed viraemia [i.e. several successive HIV-1 RNA plasma concentrations (viral loads, VL) below the limits of detection during 6 months or more of highly active antiretroviral therapy (HAART)] are unlikely to be infectious. Questions then arise: how reliable is the undetectability of the VL, given the history of measures? What factors determine reliability? Methods We assessed the probability (henceforth termed reliability) that the n+1 VL would exceed 50 or 1000 HIV-1 RNA copies/mL when the nth one had been <50 copies/mL in 6168 patients of the Swiss HIV Cohort Study who were continuing to take HAART between 2003 and 2007. General estimating equations were used to analyse potential factors of reliability. Results With a cut-off at 50 copies/mL, reliability was 84.5% (n=1), increasing to 94.5% (n=5). Compliance, the current type of HAART and the first antiretroviral therapy (ART) received (HAART or not) were predictive factors of reliability. With a cut-off at 1000 copies/mL, reliability was 97.5% (n=1), increasing to 99.1% (n=4). Chart review revealed that patients had stopped their treatment, admitted to major problems with compliance or were taking non-HAART ART in 72.2% of these cases. Viral escape caused by resistance was found in 5.6%. No explanation was found in the charts of 22.2% of cases. Conclusions After several successive VLs at <50 copies/mL, reliability reaches approximately 94% with a cut-off of 50 copies/mL and approximately 99% with a cut-off at 1000 copies/mL. Compliance is the most important factor predicting reliability. [source] Assessments of learning-related skills and interpersonal skills constructs within early childhood environments in SingaporeINFANT AND CHILD DEVELOPMENT, Issue 4 2010Sok Mui Lim Abstract Social skills are necessary for developing successful relationships and promoting learning. Interpersonal skills (IPS) are needed for maintaining friendships while learning-related skills (LRS) are required for positive classroom behaviours. In this study, we investigated the construct validity of LRS and IPS within two existing assessments: the Child Behavior Rating Scales (CBRS) and the Preschool and Kindergarten Behavior Scales,2nd edition (PKBS-2). Teachers completed the CBRS and PKBS-2 for 117 Singaporean children aged 3,6 years. Rasch analysis was used to identify items that fit the unidimensional constructs of LRS and IPS within each instrument. Specific items from within the CBRS were found to measure LRS and IPS. Within the PKBS-2, items were found to measure IPS and a new construct labelled Compliance. Instead of creating new assessment tools to measure new constructs, this study innovatively demonstrated how Rasch analysis can be used to document the existence of new constructs within already existing tools. The identification of new constucts and the use of these tools in an Asian context are presented. Copyright © 2010 John Wiley & Sons, Ltd. [source] Maternal self-efficacy beliefs, competence in parenting, and toddlers' behavior and developmental statusINFANT MENTAL HEALTH JOURNAL, Issue 2 2003Priscilla K. Coleman This study was designed to examine parenting self-efficacy beliefs as correlates of mothers' competence in parenting toddlers and as predictors of toddlers' behavior and development. Sixty-eight predominantly middle-class mother,toddler pairs participated in this study. Mothers completed questionnaires, toddlers were administered the Bayley Scales of Infant Development (BSID-II), and each dyad participated in the Crowell Procedure, which is designed to observe parent and toddler behaviors in a semistructured laboratory context. Although domain-general and domain-specific parenting self-efficacy beliefs were not associated with parenting competence, domain-specific beliefs were significantly related to toddlers' scores on the Mental Scale of the BSID-II and several behaviors observed during the Crowell Procedure (Affection Towards Mother, Avoidance of Mother, Compliance, Enthusiasm, and Negativity). Implications of the findings are discussed. ©2003 Michigan Association for Infant Mental Health. [source] A new oral delivery system for 5-ASA: Preliminary clinical findings for MMxINFLAMMATORY BOWEL DISEASES, Issue 5 2005Cosimo Prantera MD Abstract Background: Multi-matrix (MMx), a new delivery system for mesalazine, seems to release 5-aminosalicyclic acid (5-ASA) preferentially in the sigmoid colon. This study had 2 objectives: (1) to evaluate the therapeutic response to MMx in patients with active left-sided disease and (2) to gain additional insights as to how the therapy would compare with topical 5-ASA. Methods: Patients received either 1.2 g of 5-ASA MMx three times per day plus placebo enema or 4 g of 5-ASA enema plus placebo tablets for 8 weeks. The primary endpoint was clinical remission (clinical activity index ,4) at 8 weeks. Secondary endpoints were endoscopic and histologic remissions. Results: Seventy-nine patients were enrolled. Clinical remission rates at 4 and 8 weeks were 57.5% and 60.0% for patients treated with MMx and 68.4% and 50.0% for patients randomized to 5-ASA enemas, respectively (95% confidence interval for the difference at 8 weeks, ,12 to +32). Endoscopic remission was achieved by 45.0% of patients on 5-ASA MMx and by 36.8% of those on enema, whereas 15.0% and 8% of patients, respectively, showed histologic remission. Compliance was 97.0% for oral and 87.5% for topical therapy. In the enema group, compliance was 88.0% for the patients in remission and 65.5% for those with active disease. Conclusions: Preliminary studies suggest that similar rates for induction of remission can be expected from 5-ASA enemas and MMx for patients with left-sided ulcerative colitis. [source] Factors Associated with the Use of and Compliance with the IIA Standards: A Study of Anglo-culture CAEsINTERNATIONAL JOURNAL OF AUDITING, Issue 1 2009Mohammad J. Abdolmohammadi Chief audit executives (CAEs) are required to use and comply with The International Standards for the Professional Practice of Internal Auditing (Standards). However, this study finds that 13.5 percent of CAEs in Anglo-culture countries do not use the Standards. Furthermore, of those who use the Standards a significant number fail to comply with specific standards. Multivariate tests of data from CAEs in this study show that ,Length of IIA membership' and ,Internal auditing certification' are positively associated with use. Other significant variables are ,Superseded by local/government regulations or standards,',Not perceived as value added by management/board' and ,Compliance not expected in the country' that are inversely related to use. The length of training is also positively associated with compliance, while other significant variables are internal audit certification, ,Standards are too costly,',Not perceived as value added by management/board' and ,Inadequate internal audit staff' that are negatively associated with compliance. The paper ends with a discussion of the implications of these results for practice and research. [source] Internal Audit Professionalism and Section 404 Compliance: The View of Chief Audit Executives from Northeast OhioINTERNATIONAL JOURNAL OF AUDITING, Issue 1 2007Albert L. Nagy This study explores the notion that the recently heightened regulation over United States public company reporting limits the amount of professional judgment required by internal auditors, and in the long run may reduce the overall value and professionalism of the internal audit group. Our assessment is based on face-to-face interviews conducted with Chief Audit Executives (CAEs) from 17 publicly listed companies located in Northeast Ohio, United States, and is in general agreement with the extant literature on the topic. We find that despite several short-term benefits from the Section 404 work for the individual auditor (e.g., increased pay and job security), the compliance work may indeed be a threat to the long-term reputation of the internal audit profession. Based on the existing literature and the CAEs' responses, the Section 404 work does appear to be driving the internal audit profession down a new path. [source] Long-term desmopressin response in primary nocturnal enuresis: open-label, multinational studyINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 1 2009H. Lottmann Summary Background:, Primary nocturnal enuresis (PNE) is a distressing condition, particularly in severe cases (, 3 wet nights/week). A prevalent pathophysiological mechanism, especially in monosymptomatic PNE (PMNE), is commonly believed to be an insufficient increase in night-time release of antidiuretic hormone. Desmopressin, a synthetic analogue of antidiuretic hormone, has been shown to reduce the number of wet nights experienced by PMNE patients in several controlled trials. Aim: This study was performed to evaluate desmopressin treatment in the real-life clinical setting and was a large-scale, 6-month investigation of efficacy and safety in patients with severe PNE. Predictive factors for desmopressin response were also evaluated. A total of 744 children aged 5 years and above from four countries were involved in the study. Results: At baseline, patients had a median of 6 wet nights/week; at 6 months, 41% of patients had experienced , 50% reduction in the mean number of wet nights. Long-term desmopressin treatment was consistently well-tolerated across all ages, with 5% of patients experiencing any treatment-related adverse events. The strength of treatment response was associated with nocturnal diuresis (p < 0.0001) and age (p = 0.0167) in logistic regression analyses. Compliance and dosage were also associated with response and more patients experienced , 50% reduction in wet nights after 6 months' treatment than earlier in the study, suggesting the value of persistent treatment. Conclusion: This study shows that long-term desmopressin treatment in the clinical setting is effective and well-tolerated in PNE patients of 5 years and upwards. Early improvements in bedwetting of any appreciable magnitude may be rewarding, may facilitate compliance and enable good long-term response. [source] A randomised comparison of oral desmopressin lyophilisate (MELT) and tablet formulations in children and adolescents with primary nocturnal enuresisINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 9 2007H. Lottmann Summary Aims:, Desmopressin is a useful treatment for primary nocturnal enuresis (PNE), a common childhood condition that can persist into adolescence. This open-label, randomised, cross-over study evaluated the preference of children and adolescents with PNE for sublingual desmopressin oral lyophilisate (MELT) vs. tablet treatment, and the efficacy, safety, compliance and ease of use associated with each formulation. In total, 221 patients aged 5,15 years who were already receiving desmopressin tablets were randomised 1 : 1 to receive desmopressin treatment in the order MELT/tablet (n = 110) or tablet/MELT (n = 111) for 3 weeks each. Each formulation was administered in bioequivalent doses (0.2/0.4 mg tablets , 120/240 ,g MELT). Following treatment, patients were questioned regarding treatment preference. Diary card data and 100 mm Visual Analogue Scale scores were also recorded. Results:, Overall, patients preferred the MELT formulation to the tablet (56% vs. 44%; p = 0.112). This preference was age dependent (p = 0.006); patients aged < 12 years had a statistically significant preference for desmopressin MELT (p = 0.0089). Efficacy was similar for both formulations (MELT: 1.88 ± 1.94 bedwetting episodes/week; tablet: 1.90 ± 1.85 episodes/week). Ease of use of both formulations was high. Compliance (, 80%) was 94.5% for MELT patients vs. 88.9% for the tablet (p = 0.059). No serious/severe adverse events were reported. Conclusions:, There was an overall preference for the MELT, and a statistically significant preference for desmopressin MELT in children aged 5,11 years. Desmopressin MELT had similar levels of efficacy and safety at lower dosing levels than the tablet, and therefore facilitates early initiation of PNE treatment in children aged 5,6 years. [source] Effectiveness and safety of eprosartan on pulse pressure for the treatment of hypertensive patientsINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 4 2005N. R. Robles Summary A multicentre, prospective, non-comparative open-label study was conducted to assess the effect of eprosartan, 600 mg/day, on pulse pressure (PP) in patients with hypertension (stage I or II, Joint National Committee, sixth report) treated in the primary care setting, as well as safety and compliance. The duration of treatment was 16 weeks. Eprosartan decreased PP (,13 mmHg), systolic blood pressure (SBP) (,26 mmHg), diastolic blood pressure (DBP) (,13 mmHg) and mean arterial pressure (MAP) (,17.4 mmHg) significantly (p < 0.0001). The PP/MAP ratio changed significantly from 62 to 59%, so that the reduction of PP was 3% higher than the overall decrease in MAP. Twenty adverse events, mostly gastrointestinal complaints, were recorded in 12 patients (1.9%). Compliance with treatment at the end of the study was 94%. Eprosartan was a well-tolerated and an effective drug in reducing PP, SBP and DBP below the recommended levels in patients with mild-to-moderate essential hypertension, allowing a high therapeutic compliance. [source] Interceptive orthodontics in the real world of community dentistryINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2000K. Al Nimri Objective. To test the applicability and effectiveness of interceptive orthodontics in a community field trial. Design. Prospective screening for suitable malocclusions, implementation of treatment and analysis of outcomes 12 months later. Setting. Community dentistry in urban and rural areas of Northern Ireland, 1996,98. Subjects and methods. The initial sample consisted of 2002 children (1014 boys, 988 girls) who were screened in routine community dental inspections. One thousand and sixty (523 aged 9 years, 537 aged 11 years) were domiciled in the urban area of greater Belfast and 942 (479 aged 9 years, 463 aged 11 years) in the rural area of Enniskillen and Omagh, Co. Tyrone. Interventions. Interceptive orthodontic treatment. Outcome measures. Dental health component of the Index of Orthodontic Treatment Need (IOTN) and specially devised local indices of treatment outcomes. Results. With the use of an interception gauge, orthodontic screening was included in the community dental inspections without difficulty. Thirty-three per cent of children were in need of interceptive treatment. Only 20% of those in need both attended for recall and underwent treatment. Compliance was better in the rural area but the need, with particular reference to extraction of carious first molars, was greater in the urban area. The numbers of children in IOTN grades 4 and 5 fell from 69% at the beginning of the study to 42% at the end. The outcome judged by local indices was 94% in the range of complete success to minimal improvement with only 2% showing deterioration. Conclusions. One in three children screened in community dental inspections at age 9 and 11 years would benefit from interceptive orthodontics. Parents and children seem reluctant to accept offers of interceptive orthodontics and to having the treatment carried out. Among those complying fully, the interceptive measures are very successful. Not only does community interceptive orthodontics improve the condition being treated but also reduces the need for further treatment. [source] Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birthJOURNAL OF ADVANCED NURSING, Issue 11 2009Zvi Shimoni Abstract Title.,Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birth. Aim., This paper is a report of a study of the effect of empowering surgical nurses to ensure that patients receive antibiotic prophylaxis after caesarean birth. Background., Despite the consensus that single dose antibiotic prophylaxis is beneficial for women have either elective or non-elective caesarean delivery, hospitals need methods to increase compliance rates. Method., In a study in Israel in 2007 surgical nurses were empowered to ensure that a single dose of cefazolin was given to the mother after cord clamping. A computerized system was used to identify women having caesarean births, cultures sent and culture results. Compliance was determined by chart review. Rates of compliance, suspected wound infections, and confirmed wound infections in 2007 were compared to rates in 2006 before the policy change. Relative risks were calculated dividing 2007 rates by those in 2006, and 95% confidence intervals were calculated using Taylor's series that does not assume a normal distribution. Statistical significance was assessed using the chi-square test. Findings., The compliance rate was increased from 25% in 2006 to 100% in 2007 (chi-square test, P < 0·001). Suspected wound infection rates decreased from 16·8% (186/1104) to 12·6% (137/1089) after the intervention (relative risk 0·75, 95% confidence interval, 0·61,0·92). Conclusion., Surgical nurses can ensure universal compliance for antibiotic prophylaxis in women after caesarean birth, leading to a reduction in wound infections. [source] An Intervention to Increase Fluid Intake in Nursing Home Residents: Prompting and Preference ComplianceJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2001Sandra F. Simmons PhD OBJECTIVE: To evaluate a three-phase, behavioral intervention to improve fluid intake in nursing home (NH) residents. DESIGN: Controlled clinical intervention trial. SETTING: Two community NHs. PARTICIPANTS: Sixty-three incontinent NH residents. INTERVENTION: Participants were randomized into intervention and control groups. The intervention consisted of three phases for a total of 32 weeks: (1) 16 weeks of four verbal prompts to drink per day, in between meals; (2) 8 weeks of eight verbal prompts per day, in between meals; and (3) 8 weeks of eight verbal prompts per day, in between meals, plus compliance with participant beverage preferences. MEASUREMENTS: Between-meal fluid intake was measured in ounces by research staff during all three phases of the intervention. Percentage of fluids consumed during meals was also estimated by research staff for a total of nine meals per participant (3 consecutive days) at baseline and at 8 and 32 weeks into the intervention. Serum osmolality, blood urea nitrogen, and creatinine values were obtained for all participants in one of the two sites at the same three time points. RESULTS: The majority (78%) of participants increased their fluid intake between meals in response to the increase in verbal prompts (phase 1 to 2). A subset of residents (21%), however, only increased their fluid intake in response to beverage preference compliance (phase 3). There was a significant reduction in the proportion of intervention participants who had laboratory values indicative of dehydration compared with the control participants. Cognitive and nutritional status were predictive of residents' responsiveness to the intervention. CONCLUSIONS: A behavioral intervention that consists of verbal prompts and beverage preference compliance was effective in increasing fluid intake among most of a sample of incontinent NH residents. Verbal prompting alone was effective in improving fluid intake in the more cognitively impaired residents, whereas preference compliance was needed to increase fluid intake among less cognitively impaired NH residents. [source] Barriers to Caregiver Compliance with Eating and Drinking Recommendations for Adults with Intellectual Disabilities and DysphagiaJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2006Darren D. Chadwick Background, There is scant research on the subject of dysphagia and people with intellectual disabilities. This study explores the barriers which caregivers believe make following Speech and Language Therapists' (SLTs) dysphagia management strategies more difficult. Method, Semi-structured open-ended interviews were conducted with 46 caregivers who supported 40 intellectually disabled adults with dysphagia. Results, Caregivers perceived particular difficulties in modifying food and drinks to safe consistencies, achieving the agreed positioning during mealtimes, and in using support and prompting strategies. Problematic support and prompting strategies included difficulties with pacing correctly; facilitating people to adequately relax and concentrate; observing and prompting people to pace suitably and take safe amounts of food and drink in each mouthful. Additional barriers identified included time pressures, staff turnover and insufficient reviewing of SLT management strategies by caregivers. Conclusions, Findings suggest that additional training and monitoring is required to ensure caregivers are aware of their role and responsibility in promoting safe oral intake for adults with dysphagia and intellectual disabilities. Ongoing support is suggested for people with intellectual disabilities and dysphagia to help them understand the reasoning behind management strategies. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||