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Greater Compliance (greater + compliance)
Selected AbstractsTHE MIRACLE OF THE CELLS: AN EXPERIMENTAL STUDY OF INTERVENTIONS TO INCREASE PAYMENT OF COURT-ORDERED FINANCIAL OBLIGATIONS,CRIMINOLOGY AND PUBLIC POLICY, Issue 1 2008DAVID WEISBURD Research Summary: In this article, we present findings from an experimental study of an innovative program in fine enforcement developed by the Administrative Office of the Courts (AOC) of New Jersey, termed Project MUSTER (MUST Earn Restitution). The project was initiated by the New Jersey AOC as a response to concerns among probation personnel that probationers sentenced to monetary penalties often failed to meet their financial obligations. The program sought to increase payment of court-ordered financial obligations among probationers who are seriously delinquent in paying fines, penalties, and restitution, and was designed to "strengthen the effectiveness of restitution and fine sanctions by forcing those offenders who have the ability to make regular payments to do so." Project MUSTER relied on a combination of intensive probation, threats of violation to court and incarceration, and community service. We find that probationers sentenced to Project MUSTER were significantly more likely to pay court-ordered financial obligations than were those who experienced regular probation supervision. However, probationers sentenced to a second treatment group, in which the only intervention was violation of probation (one part of the MUSTER program), had similar outcomes to the MUSTER condition. These findings suggest that the main cause of fine payment was a deterrent threat of possible incarceration, which is often termed the "miracle of the cells." Policy Implications: Our study shows that it is possible to gain greater compliance with court-ordered financial obligations and that such compliance may be gained with a relatively simple and straightforward criminal justice intervention. Threats of violation of probation are an effective tool for gaining compliance with financial obligations. Given the growing interest in monetary penalties as an alternative to incarceration, these findings have particular policy importance. [source] Medical treatment of benign prostatic hyperplasia: physician and patient preferences and satisfactionINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2010M. Emberton Summary Practice guidelines acknowledge the importance of patient preferences in determining the appropriate treatment of benign prostatic hyperplasia (BPH). Recent literature suggests that patient and physician perspectives and satisfaction with BPH treatment management may differ; this may have an impact on clinical outcomes and patient compliance. This review evaluates patients' and physicians' preferred treatment options for managing BPH and patient satisfaction with therapy. A Medline-based systematic review using the terms ,Benign prostatic hyperplasia' + ,Patient preference/perception/satisfaction' or ,Physician/urologist preference/perception' was performed. Patients prefer therapies affecting long-term disease progression over those that provide short-term symptom improvement, which contrasts with the beliefs of their physicians. The prescribing behaviour of urologists and primary care physicians can be very varied. Studies of patient satisfaction with specific treatments generally show a high level of overall satisfaction, but cross-study comparisons are limited because of heterogeneity in study design. The evidence to date suggests that patients' views and beliefs and those of their physician may not always be in agreement. Improved physician,patient communication will help determine the best treatment option for patients with BPH and may ensure greater compliance and treatment success. [source] Prevention of Postmenopausal Bone Loss by a Low-Magnitude, High-Frequency Mechanical Stimuli: A Clinical Trial Assessing Compliance, Efficacy, and Safety,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 3 2004Clinton Rubin Abstract A 1-year prospective, randomized, double-blind, and placebo-controlled trial of 70 postmenopausal women demonstrated that brief periods (<20 minutes) of a low-level (0.2g, 30 Hz) vibration applied during quiet standing can effectively inhibit bone loss in the spine and femur, with efficacy increasing significantly with greater compliance, particularly in those subjects with lower body mass. Introduction: Indicative of the anabolic potential of mechanical stimuli, animal models have demonstrated that short periods (<30 minutes) of low-magnitude vibration (<0.3g), applied at a relatively high frequency (20,90 Hz), will increase the number and width of trabeculae, as well as enhance stiffness and strength of cancellous bone. Here, a 1-year prospective, randomized, double-blind, and placebo-controlled clinical trial in 70 women, 3,8 years past the menopause, examined the ability of such high-frequency, low-magnitude mechanical signals to inhibit bone loss in the human. Materials and Methods: Each day, one-half of the subjects were exposed to short-duration (two 10-minute treatments/day), low-magnitude (2.0 m/s2 peak to peak), 30-Hz vertical accelerations (vibration), whereas the other half stood for the same duration on placebo devices. DXA was used to measure BMD at the spine, hip, and distal radius at baseline, and 3, 6, and 12 months. Fifty-six women completed the 1-year treatment. Results and Conclusions: The detection threshold of the study design failed to show any changes in bone density using an intention-to-treat analysis for either the placebo or treatment group. Regression analysis on the a priori study group demonstrated a significant effect of compliance on efficacy of the intervention, particularly at the lumbar spine (p = 0.004). Posthoc testing was used to assist in identifying various subgroups that may have benefited from this treatment modality. Evaluating those in the highest quartile of compliance (86% compliant), placebo subjects lost 2.13% in the femoral neck over 1 year, whereas treatment was associated with a gain of 0.04%, reflecting a 2.17% relative benefit of treatment (p = 0.06). In the spine, the 1.6% decrease observed over 1 year in the placebo group was reduced to a 0.10% loss in the active group, indicating a 1.5% relative benefit of treatment (p = 0.09). Considering the interdependence of weight, the spine of lighter women (<65 kg), who were in the highest quartile of compliance, exhibited a relative benefit of active treatment of 3.35% greater BMD over 1 year (p = 0.009); for the mean compliance group, a 2.73% relative benefit in BMD was found (p = 0.02). These preliminary results indicate the potential for a noninvasive, mechanically mediated intervention for osteoporosis. This non-pharmacologic approach represents a physiologically based means of inhibiting the decline in BMD that follows menopause, perhaps most effectively in the spine of lighter women who are in the greatest need of intervention. [source] Biomechanics of Diabetic BladdersLUTS, Issue 2009Chung Cheng WANG Objectives: Biomechanics is the mechanics applied to biology and we hereby review bladder biomechanics in diabetic bladder dysfunction. Methods: The important mechanical properties of bladder tissue include the stress-strain relationship, viscoelasticity and active contraction. Using biaxial mechanical testing methods, the diabetic bladders exhibited non-linear stress-strain mechanical relationships with increasing stiffness at higher stretches in both circumferential and longitudinal directions. Results: The diabetic bladders showed mechanical anisotropy with a greater compliance in the circumferential direction than in the longitudinal direction. The time-course study suggested that diuresis mainly contributed to the "early" changes of the mechanical properties with "late" changes induced by other diabetic effects. Conclusion: The biomechanical study of the urinary bladder has offered a novel understanding of the pathophysiology of diabetic cystopathy and we believe the collaboration of urology and engineering will contribute greatly to the treatment of diabetic bladder dysfunction in the future. [source] The Consent and Prescription Compliance (COPRECO) Study: Does Obtaining Consent in the Emergency Department Affect Study Results in a Telephone Follow-up Study of Medication Compliance?ACADEMIC EMERGENCY MEDICINE, Issue 10 2008CCFP(EM), Samuel G. Campbell MB BCh Abstract Objectives:, The objectives were to determine whether mandated research requirements for consent in the emergency department (ED) falsely distorts the results of a survey of patient-reported compliance with ED prescriptions and, in addition, to ascertain the level of patient compliance to medication instructions and find out the degree of displeasure expressed by patients called without prior consent. Methods:, Patients given new prescriptions for a medicine to be taken regularly over a period of less than 30 days were eligible. A convenience sample of eligible patients was randomized to having consent obtained during their ED visit or at the time of telephone follow-up. Patients were called 7,10 days after their ED visit to determine their compliance with the prescription. Compliance rates between the two groups were compared, as was the prevalence of displeasure expressed by patients called without prior consent. Results:, Of 430 enrolled patients, 221 were randomized to receive ED consent for telephone follow-up, and 209 received telephone follow-up without prior ED consent. Telephone follow-up was successful in 318 patients (74%). The rate of noncompliance was slightly higher in the group without ED consent, 74/149 (50%; 95% confidence interval [CI] = 41% to 58%) than the group who gave ED consent for telephone follow-up, 67/169 (40%; 95% CI = 32% to 42%; p = 0.07). Among the two groups, 141/318 (44%) did not fill the prescription (n = 42) or took it incorrectly (n = 99). Only 1 (0.7%) of the 149 patients with successful telephone follow-up without prior ED consent expressed displeasure at this telephone call. Conclusions:, Medicine noncompliance is a significant issue for patients discharged from the ED in this study. Although there was a trend toward greater compliance in patients who consented to the follow-up call, this did not reach statistical significance. ED patients do not object to receiving telephone follow-up for a research survey without giving prior consent. [source] | ||||||||||