Sample records for identified compliance gaps

  1. Physician 'defiance' towards hand hygiene compliance: Is there a theory-practice-ethics gap?

    PubMed

    Mortell, Manfred; Balkhy, Hanan H; Tannous, Elias B; Jong, Mei Thiee

    2013-07-01

    The theory-practice gap has always existed [1,2]. This gap is often cited as a culmination of theory being idealistic and impractical, even if practical and beneficial, is often ignored. Most of the evidence relating to the non-integration of theory and practice assumes that environmental factors are responsible and will affect learning and practice outcomes, hence the gap. Therefore, the author believes that to 'bridge the gap' between theory and practice, an additional dimension is required: ethics. A moral duty and obligation ensuring theory and practice integrate. In order to effectively implement new practices, one must deem these practices as worthy and relevant to their role as healthcare providers (HCP). Hence, this introduces a new concept which the author refers to as the theory-practice-ethics gap. This theory-practice-ethics gap must be considered when reviewing some of the unacceptable outcomes in healthcare practice [3]. The literature suggests that there is a crisis of ethics where theory and practice integrate, and healthcare providers are failing to fulfill our duty as patient advocates. Physician hand hygiene practices and compliance at King Abdulaziz Cardiac Centre (KACC) are consistent with those of other physicians in the global healthcare arena. That is one of noncompliance to King Abdulaziz Medical City (KAMC) organizational expectations and the World Health Organization (WHO) requirements? An observational study was conducted on the compliance of cardiac surgeons, cardiologists and nurses in the authors' cardiac center from January 2010 to December 2011. The hand hygiene (HH) compliance elements that were evaluated pertained to the WHO's five moments of HH recommendations. The data was obtained through direct observation by KAMC infection prevention and control practitioners. Physician hand hygiene compliance at KACC was consistently less than 60%, with nurses regularly encouraging physicians to be diligent with hand hygiene practices in the

  2. Hand hygiene compliance: is there a theory-practice-ethics gap?

    PubMed

    Mortell, Manfred

    Practice is usually based on tradition, rituals and outdated information; there is often an additional gap between theoretical knowledge and its application in practice. This theory-practice gap has long existed (Allmark, 1995; Hewison et al, 1996). It often arises when theory is ignored because it is seen as idealistic and impractical, even if it is practical and beneficial. Most research relating to the lack of integration between theory and practice has concluded that environmental factors are responsible and will affect learning and practice outcomes. The author believes an additional dimension of ethics is required to bridge the gap between theory and practice. This would be a moral obligation to ensure theory and practice are integrated. To implement new practices effectively, healthcare practitioners must deem these practices worthwhile and relevant to their role. This introduces a new concept that the author calls the theory-practice-ethics gap. This theory-practice-ethics gap must be considered when examining some of the unacceptable outcomes in healthcare practice (Mortell, 2009). The literature suggests that there is a crisis of ethics where theory and practice integrate, and practitioners are failing to fulfil their duty as providers of healthcare and as patient advocates. This article examines the theory-practice-ethics gap when applied to hand hygiene. Non-compliance exists in hand hygiene among practitioners, which may increase patient mortality and morbidity rates, and raise healthcare costs. Infection prevention and control programmes to improve hand hygiene among staff include: ongoing education and training; easy access to facilities such as wash basins; antiseptic/alcohol handgels that are convenient, effective, and skin- and user-friendly; and organisational recognition and support for clinicians in hand washing and handgel practices. Yet these all appear to have failed to achieve the required and desired compliance in hand hygiene.

  3. Using an interdisciplinary approach to identify factors that affect clinicians' compliance with evidence-based guidelines.

    PubMed

    Gurses, Ayse P; Marsteller, Jill A; Ozok, A Ant; Xiao, Yan; Owens, Sharon; Pronovost, Peter J

    2010-08-01

    Our objective was to identify factors that affect clinicians' compliance with the evidence-based guidelines using an interdisciplinary approach and develop a conceptual framework that can provide a comprehensive and practical guide for designing effective interventions. A literature review and a brainstorming session with 11 researchers from a variety of scientific disciplines were used to identify theoretical and conceptual models describing clinicians' guideline compliance. MEDLINE, EMBASE, CINAHL, and the bibliographies of the papers identified were used as data sources for identifying the relevant theoretical and conceptual models. Thirteen different models that originated from various disciplines including medicine, rural sociology, psychology, human factors and systems engineering, organizational management, marketing, and health education were identified. Four main categories of factors that affect compliance emerged from our analysis: clinician characteristics, guideline characteristics, system characteristics, and implementation characteristics. Based on these findings, we developed an interdisciplinary conceptual framework that specifies the expected interrelationships among these four categories of factors and their impact on clinicians' compliance. An interdisciplinary approach is needed to improve clinicians' compliance with evidence-based guidelines. The conceptual framework from this research can provide a comprehensive and systematic guide to identify barriers to guideline compliance and design effective interventions to improve patient safety.

  4. A New Approach to Identifying the Drivers of Regulation Compliance Using Multivariate Behavioural Models

    PubMed Central

    Thomas, Alyssa S.; Milfont, Taciano L.; Gavin, Michael C.

    2016-01-01

    Non-compliance with fishing regulations can undermine management effectiveness. Previous bivariate approaches were unable to untangle the complex mix of factors that may influence fishers’ compliance decisions, including enforcement, moral norms, perceived legitimacy of regulations and the behaviour of others. We compared seven multivariate behavioural models of fisher compliance decisions using structural equation modeling. An online survey of over 300 recreational fishers tested the ability of each model to best predict their compliance with two fishing regulations (daily and size limits). The best fitting model for both regulations was composed solely of psycho-social factors, with social norms having the greatest influence on fishers’ compliance behaviour. Fishers’ attitude also directly affected compliance with size limit, but to a lesser extent. On the basis of these findings, we suggest behavioural interventions to target social norms instead of increasing enforcement for the focal regulations in the recreational blue cod fishery in the Marlborough Sounds, New Zealand. These interventions could include articles in local newspapers and fishing magazines highlighting the extent of regulation compliance as well as using respected local fishers to emphasize the benefits of compliance through public meetings or letters to the editor. Our methodological approach can be broadly applied by natural resource managers as an effective tool to identify drivers of compliance that can then guide the design of interventions to decrease illegal resource use. PMID:27727292

  5. Development of a framework to identify research gaps from systematic reviews.

    PubMed

    Robinson, Karen A; Saldanha, Ian J; McKoy, Naomi A

    2011-12-01

    Our objective was to develop a framework to identify research gaps from systematic reviews. We reviewed the practices of (1) evidence-based practice centers (EPCs), and (2) other organizations that conduct evidence syntheses. We developed and pilot tested a framework for identifying research gaps. Four (33%) EPCs and three (8%) other organizations reported using an explicit framework to determine research gaps. Variations of the PICO (population, intervention, comparison, outcomes) framework were most common. We developed a framework incorporating both the characterization of the gap using PICOS elements (also including setting) and the identification of the reason(s) why the gap exists as (1) insufficient or imprecise information, (2) biased information, (3) inconsistency or unknown consistency, and (4) not the right information. We mapped each of these reasons to concepts from three common evidence-grading systems. Our framework determines from systematic reviews where the current evidence falls short and why or how the evidence falls short. This explicit identification of research gaps will allow systematic reviews to maximally inform the types of questions that need to be addressed and the types of studies needed to address the research gaps. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Coverage of, and compliance with, mass drug administration under the programme to eliminate lymphatic filariasis in India: a systematic review.

    PubMed

    Babu, Bontha V; Babu, Gopalan R

    2014-09-01

    India's mass drug administration (MDA) programme to eliminate lymphatic filariasis (PELF) covers all 250 endemic districts, but compliance with treatment is not adequate for the programme to succeed in eradicating this neglected tropical disease. The objective of our study was to systematically review published studies on the coverage of and compliance with MDA under the PELF in India. We searched several databases-PubMed/Medline, Google Scholar, CINAHL/EBSCO, Web of Knowledge (including Web of Science) and OVID-and by applying selection criteria identified a total of 36 papers to include in the review. Overall MDA coverage rates varied between 48.8% and 98.8%, while compliance rates ranged from 20.8% to 93.7%. The coverage-compliance gap is large in many MDA programmes. The effective level of compliance, ≥65%, was reported in only 10 of a total of 31 MDAs (5 of 20 MDAs in rural areas and 2 of 12 MDAs in urban areas). The review has identified a gap between coverage and compliance, and potentially correctable causes of this gap. These causes need to be addressed if the Indian programme is to advance towards elimination of lymphatic filariasis. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. 24 CFR 1000.510 - What happens if tribal monitoring identifies compliance concerns?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false What happens if tribal monitoring... HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.510 What happens if tribal monitoring identifies compliance...

  8. 24 CFR 1000.510 - What happens if tribal monitoring identifies compliance concerns?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What happens if tribal monitoring... HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.510 What happens if tribal monitoring identifies compliance...

  9. 24 CFR 1000.510 - What happens if tribal monitoring identifies compliance concerns?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false What happens if tribal monitoring... HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.510 What happens if tribal monitoring identifies compliance...

  10. 24 CFR 1000.510 - What happens if tribal monitoring identifies compliance concerns?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false What happens if tribal monitoring... HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.510 What happens if tribal monitoring identifies compliance...

  11. 24 CFR 1000.510 - What happens if tribal monitoring identifies compliance concerns?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false What happens if tribal monitoring... HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.510 What happens if tribal monitoring identifies compliance...

  12. The use of medication compliance devices by district nursing services.

    PubMed

    McGraw, C; Drennan, V

    2000-07-01

    This article presents a critical review of the literature relating to medication compliance devices and the findings of a survey that examined the use of such devices by district nursing services. The UKCC (1992) does not regard the loading of compliance devices by nurses as safe practice; however, compliance devices continue to be used by district nurses. The evidence base concerning the value and use of medication compliance devices is examined and significant gaps in the literature relating to the use of such devices are identified. There is an absence of studies that focus on the effect of compliance devices on adherence among older patients and the nature and frequency of drug administration errors involving these devices. The survey findings show that nurse-loaded compliance devices are used in over one-third of the sample. Further research is necessary to assess the clinical effectiveness of, and clinical risk attached to, compliance devices for older patients in the community. It is suggested that this is an issue of serious concern for primary care groups considering the principles of clinical governance.

  13. Model of areas for identifying risks influencing the compliance of technological processes and products

    NASA Astrophysics Data System (ADS)

    Misztal, A.; Belu, N.

    2016-08-01

    Operation of every company is associated with the risk of interfering with proper performance of its fundamental processes. This risk is associated with various internal areas of the company, as well as the environment in which it operates. From the point of view of ensuring compliance of the course of specific technological processes and, consequently, product conformity with requirements, it is important to identify these threats and eliminate or reduce the risk of their occurrence. The purpose of this article is to present a model of areas of identifying risk affecting the compliance of processes and products, which is based on multiregional targeted monitoring of typical places of interference and risk management methods. The model is based on the verification of risk analyses carried out in small and medium-sized manufacturing companies in various industries..

  14. Beyond surgical care improvement program compliance: antibiotic prophylaxis implementation gaps.

    PubMed

    Hawkins, Russell B; Levy, Shauna M; Senter, Casey E; Zhao, Jane Y; Doody, Kaitlin; Kao, Lillian S; Lally, Kevin P; Tsao, KuoJen

    2013-10-01

    Despite increased compliance with Surgical Care Improvement Project infection measures, surgical-site infections are not decreasing. The aim of this study was to test the hypothesis that documented compliance with antibiotic prophylaxis guidelines on a pediatric surgery service does not reflect implementation fidelity or adherence to guidelines as intended. A 7-week observational study of elective pediatric surgical cases was conducted. Adherence was evaluated for appropriate administration, type, timing, weight-based dosing, and redosing of antibiotics. Prophylactic antibiotics were administered appropriately in 141 of 143 cases (99%). Of 100 cases (70%) in which antibiotic prophylaxis was indicated, compliance was documented in 100% cases in the electronic medical record, but only 48% of cases adhered to all 5 guidelines. Lack of adherence was due primarily to dosing or timing errors. Lack of implementation fidelity in antibiotic prophylaxis guidelines may partly explain the lack of expected reduction in surgical-site infections. Future studies of Surgical Care Improvement Project effectiveness should measure adherence and implementation fidelity rather than just documented compliance. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Nonlinear Pricing in Drug Benefits and Medication Use: The Case of Statin Compliance in Medicare Part D

    PubMed Central

    Jung, Kyoungrae; Feldman, Roger; McBean, A Marshall

    2014-01-01

    Objective To examine how enrollees' statin compliance responds to expected prices in Medicare Part D, which features a nonlinear price schedule due to a coverage gap. Data Sources/Study Setting Prescription Drug Event data for a 5 percent random sample of Medicare Advantage Prescription Drug Plan enrollees in 2008 who did not receive a low-income subsidy. Study Design We analyze statin compliance prior to the coverage gap, where the “effective price” is higher than the actual copayment for drugs because consumers anticipate that more spending will make them more likely to reach the gap. We construct each enrollee's effective price as her expected price at the end of the year, which is the weighted average between pre-gap and in-gap copayments with the weight being the predicted probability of hitting the gap. Compliance is defined as at least 80 percent of days covered. Principal Findings Part D enrollees' pre-gap statin compliance decreases by 3.7–4.7 percentage points for a $10 increase in the effective price. Conclusion The presence of a coverage gap decreases statin compliance prior to the gap, suggesting that incorporating expected future prices is important to assess the full impact of cost sharing on drug compliance under nonlinear price schedules. PMID:24354765

  16. Identifying the Average Causal Mediation Effects with Multiple Mediators in the Presence of Treatment Non-Compliance

    ERIC Educational Resources Information Center

    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…

  17. Clinical staff nurse leadership: Identifying gaps in competency development.

    PubMed

    Franks-Meeks, Sherron

    2018-01-01

    To date, there has been no development of a complete, applicable inventory of clinical staff nurse (CSN) leadership role competencies through a valid and reliable methodology. Further, the CSN has not been invited to engage in the identification, definition, or development of their own leadership competencies. Compare existing leadership competencies to identify and highlight gaps in clinical staff nurse leadership role competency development and validation. Literature review. The CSN has not participated in the development of CSN leadership role competencies, nor have the currently identified CSN leadership role competencies been scientifically validated through research. Finally, CSN leadership role competencies are incomplete and do not reflect the CSN perspective. © 2017 Wiley Periodicals, Inc.

  18. Barriers to compliance with evidence-based care in trauma.

    PubMed

    Rayan, Nadine; Barnes, Sunni; Fleming, Neil; Kudyakov, Rustam; Ballard, David; Gentilello, Larry M; Shafi, Shahid

    2012-03-01

    We have preciously demonstrated that trauma patients receive less than two-thirds of the care recommended by evidence-based medicine. The purpose of this study was to identify patients least likely to receive optimal care. Records of a random sample of 774 patients admitted to a Level I trauma center (2006-2008) with moderate to severe injuries (Abbreviated Injury Scale score ≥3) were reviewed for compliance with 25 trauma-specific processes of care (T-POC) endorsed by Advanced Trauma Life Support, Eastern Association for the Surgery of Trauma, the Brain Trauma Foundation, Surgical Care Improvement Project, and the Glue Grant Consortium based on evidence or consensus. These encompassed all aspects of trauma care, including initial evaluation, resuscitation, operative care, critical care, rehabilitation, and injury prevention. Multivariate logistic regression was used to identify patients likely to receive recommended care. Study patients were eligible for a total of 2,603 T-POC, of which only 1,515 (58%) were provided to the patient. Compliance was highest for T-POC involving resuscitation (83%) and was lowest for neurosurgical interventions (17%). Increasing severity of head injuries was associated with lower compliance, while intensive care unit stay was associated with higher compliance. There was no relationship between compliance and patient demographics, socioeconomic status, overall injury severity, or daily volume of trauma admissions. Little over half of recommended care was delivered to trauma patients with moderate to severe injuries. Patients with increasing severity of traumatic brain injuries were least likely to receive optimal care. However, differences among patient subgroups are small in relation to the overall gap between observed and recommended care. II.

  19. 42 CFR 423.2340 - Compliance monitoring and civil money penalties.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Compliance monitoring and civil money penalties. 423.2340 Section 423.2340 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH... BENEFIT Medicare Coverage Gap Discount Program § 423.2340 Compliance monitoring and civil money penalties...

  20. 42 CFR 423.2340 - Compliance monitoring and civil money penalties.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Compliance monitoring and civil money penalties... BENEFIT Medicare Coverage Gap Discount Program § 423.2340 Compliance monitoring and civil money penalties... Agreement. (b) Basis for imposing civil money penalties. CMS imposes a civil money penalty (CMP) on a...

  1. 42 CFR 423.2340 - Compliance monitoring and civil money penalties.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Compliance monitoring and civil money penalties... BENEFIT Medicare Coverage Gap Discount Program § 423.2340 Compliance monitoring and civil money penalties... Agreement. (b) Basis for imposing civil money penalties. CMS imposes a civil money penalty (CMP) on a...

  2. Research Ethics Review: Identifying Public Policy and Program Gaps

    PubMed Central

    Strosberg, Martin A.; Gefenas, Eugenijus; Famenka, Andrei

    2014-01-01

    We present an analytical frame-work for use by fellows of the Fogarty International Center–sponsored Advanced Certificate Program in Research Ethics for Central and Eastern Europe to identify gaps in the public policies establishing research ethics review systems that impede them from doing their job of protecting human research subjects. The framework, illustrated by examples from post-Communist countries, employs a logic model based on the public policy and public management literature. This paper is part of a collection of papers analyzing the Fogarty International Center’s International Research Ethics Education and Curriculum program. PMID:24782068

  3. Identifying knowledge-attitude-practice gaps to enhance HPV vaccine diffusion.

    PubMed

    Cohen, Elisia L; Head, Katharine J

    2013-01-01

    To examine differences in knowledge, attitudes, and related practices among adopters and nonadopters of the human papillomavirus (HPV) vaccine, the researchers conducted 83 in-depth interviews with 18- to 26-year-old women. The study identified knowledge-attitude-practice gaps in the context of the HPV vaccine to explain why diffusion of a preventive innovation (such as the HPV vaccine) requires targeted risk communication strategies in order to increase demand. Salient findings included similarities between vaccinated and unvaccinated women's lack of knowledge and uncertainties about HPV and cervical cancer. Vaccinated women who had no knowledge of HPV or no-risk/low-risk perceptions of HPV reported receiving vaccination, indicating HPV risk protection behavior could precede knowledge acquisition for vaccinated women. These vaccinated women identified an interpersonal network supportive of vaccination and reported supportive social influences. Among unvaccinated women, unsupportive vaccination attitudes included low perceived personal risk of HPV. In contrast, unvaccinated women often cited erroneous beliefs that HPV could be avoided by abstinence, monogamy, and knowledge of their partners' sexual history as reasons that the vaccine was not personally relevant. Unvaccinated women cited interpersonal influences that activated short- and long-term vaccination safety and efficacy concerns. Different levels of fear regarding the HPV vaccine may underlie (a) attitudinal differences between vaccinated and unvaccinated women in perceived vaccination value and (b) attitude-practice gaps.

  4. Closing the Math Gap of Native American Students Identified as Learning Disabled

    ERIC Educational Resources Information Center

    Hankes, Judith; Skoning, Stacey; Fast, Gerald; Mason-Williams, Loretta

    2013-01-01

    This article serves as an overview of activities and selected assessment findings of a three-year research study titled, Closing the Mathematics Achievement Gap of Native American Students Identified as Learning Disabled Project (CMAG Project). Methods used were problem-based, consistent with those of Cognitively Guided Instruction, and culturally…

  5. Identifying gaps, barriers, and solutions in implementing pressure ulcer prevention programs.

    PubMed

    Jankowski, Irene M; Nadzam, Deborah Morris

    2011-06-01

    Patients continue to suffer from pressure ulcers (PUs), despite implementation of evidence-based pressure ulcer (PU) prevention protocols. In 2009, Joint Commission Resources (JCR) and Hill-Rom created the Nurse Safety Scholar-in-Residence (nurse scholar) program to foster the professional development of expert nurse clinicians to become translators of evidence into practice. The first nurse scholar activity has focused on PU prevention. Four hospitals with established PU programs participated in the PU prevention implementation project. Each hospital's team completed an inventory of PU prevention program components and provided copies of accompanying documentation, along with prevalence and incidence data. Site visits to the four participating hospitals were arranged to provide opportunities for more in-depth analysis and support. Following the initial site visit, the project team at each hospital developed action plans for the top three barriers to PU program implementation. A series of conference calls was held between the site visits. Pressure Ulcer Program Gaps and Recommendations. The four hospitals shared common gaps in terms of limitations in staff education and training; lack of physician involvement; limited involvement of unlicensed nursing staff; lack of plan for communicating at-risk status; and limited quality improvement evaluations of bedside practices. Detailed recommendations were identified for addressing each of these gaps. these Recommendations for eliminating gaps have been implemented by the participating teams to drive improvement and to reduce hospital-acquired PU rates. The nurse scholars will continue to study implementation of best practices for PU prevention.

  6. A Review of Factors That Influence Individual Compliance with Mass Drug Administration for Elimination of Lymphatic Filariasis

    PubMed Central

    Krentel, Alison; Fischer, Peter U.; Weil, Gary J.

    2013-01-01

    Background The success of programs to eliminate lymphatic filariasis (LF) depends in large part on their ability to achieve and sustain high levels of compliance with mass drug administration (MDA). This paper reports results from a comprehensive review of factors that affect compliance with MDA. Methodology/Principal Findings Papers published between 2000 and 2012 were considered, and 79 publications were included in the final dataset for analysis after two rounds of selection. While results varied in different settings, some common features were associated with successful programs and with compliance by individuals. Training and motivation of drug distributors is critically important, because these people directly interact with target populations, and their actions can affect MDA compliance decisions by families and individuals. Other important programmatic issues include thorough preparation of personnel, supplies, and logistics for implementation and preparation of the population for MDA. Demographic factors (age, sex, income level, and area of residence) are often associated with compliance by individuals, but compliance decisions are also affected by perceptions of the potential benefits of participation versus the risk of adverse events. Trust and information can sometimes offset fear of the unknown. While no single formula can ensure success MDA in all settings, five key ingredients were identified: engender trust, tailor programs to local conditions, take actions to minimize the impact of adverse events, promote the broader benefits of the MDA program, and directly address the issue of systematic non-compliance, which harms communities by prolonging their exposure to LF. Conclusions/Significance This review has identified factors that promote coverage and compliance with MDA for LF elimination across countries. This information may be helpful for explaining results that do not meet expectations and for developing remedies for ailing MDA programs. Our

  7. Critical Reflection to Identify Gaps between Espoused Theory and Theory-in-Use

    ERIC Educational Resources Information Center

    Savaya, Riki; Gardner, Fiona

    2012-01-01

    Critical reflection (CR) is a process by which one may identify the assumptions governing one's actions, question them, and develop alternative behaviors. This article presents two cases that demonstrate the use of CR to raise social workers' awareness of gaps between what Schon and Argryis term social workers' "espoused theories" and the…

  8. Developing GAP Training for Growers: Perspectives from Pennsylvania Supermarkets

    ERIC Educational Resources Information Center

    Tobin, Daniel; Thomson, Joan; LaBorde, Luke; Bagdonis, Jessica

    2011-01-01

    Major supermarket chains increasingly are requiring their produce suppliers to provide evidence of compliance with on-farm food safety standards, known as Good Agricultural Practices (GAPs). To develop a relevant GAP training curriculum that meets the needs of Pennsylvania growers, supermarkets that operate in the state were surveyed to determine…

  9. Identifying the Gaps in Practice for Combating Lead in Drinking Water in Hong Kong

    PubMed Central

    Lee, Wai Ling; Jia, Jie; Bao, Yani

    2016-01-01

    Excessive lead has been found in drinking water in Hong Kong in tests carried out in 2015. Investigations have identified that the problem in public rental housing estates was caused by the problematic solders used in the plumbing, and recommendations on enhancing the quality control system and strengthening the relevant water quality standards have been proposed. The cause for the same problem happening in other premises where soldering has not been adopted for water pipe connections is left unidentified. Considering the unidentified cause and the recommendations made, this study aims to identify the gaps in practice followed in Hong Kong for safeguarding the water quality of new installations. A holistic review of governing ordinances and regulations, products and materials used and the testing and commissioning requirements adopted in Hong Kong and elsewhere in the world were conducted. Based on international practices and parametric analysis, it was found that there are gaps in practices followed in Hong Kong, which are directly and indirectly leading to the lead-in-water crisis. Recommendations for improvement in the quality control system, and the water quality standards including the allowable lead content and leaching limit for products and materials and the testing and commissioning requirements on plumbing installations have been made. The review and the identified gaps would become useful reference for countries in strengthening their relevant water quality standards. PMID:27706062

  10. Identifying the Gaps in Practice for Combating Lead in Drinking Water in Hong Kong.

    PubMed

    Lee, Wai Ling; Jia, Jie; Bao, Yani

    2016-09-30

    Excessive lead has been found in drinking water in Hong Kong in tests carried out in 2015. Investigations have identified that the problem in public rental housing estates was caused by the problematic solders used in the plumbing, and recommendations on enhancing the quality control system and strengthening the relevant water quality standards have been proposed. The cause for the same problem happening in other premises where soldering has not been adopted for water pipe connections is left unidentified. Considering the unidentified cause and the recommendations made, this study aims to identify the gaps in practice followed in Hong Kong for safeguarding the water quality of new installations. A holistic review of governing ordinances and regulations, products and materials used and the testing and commissioning requirements adopted in Hong Kong and elsewhere in the world were conducted. Based on international practices and parametric analysis, it was found that there are gaps in practices followed in Hong Kong, which are directly and indirectly leading to the lead-in-water crisis. Recommendations for improvement in the quality control system, and the water quality standards including the allowable lead content and leaching limit for products and materials and the testing and commissioning requirements on plumbing installations have been made. The review and the identified gaps would become useful reference for countries in strengthening their relevant water quality standards.

  11. Identifying Anomalous Behaviour in AIS Data: Loitering and Gaps in Transmission as Indicators of IUU Associated Behaviour.

    NASA Astrophysics Data System (ADS)

    Ford, J.; Peel, D.; Wilcox, C.; Kroodsma, D.

    2016-12-01

    Identifying anomalous behaviour associated with Illegal, Unreported and Unregulated (IUU) fishing including supportive activities such as transshipment, is a key step to combating IUU fishing. We use spatial statistical models and Automatic Identification System (AIS) data to identify anomalous activity, specifically various indicators of loitering behaviours (for example, vessels travelling slower than expected, perhaps rendezvousing for transshipment), and gaps in AIS transmissions. Gaps occur for three basic reasons: saturation of the system in locations with high vessel density; poor quality transmissions due to equipment on the vessel or receiver; and intentional disabling of AIS transmitters. Resolving which of these mechanisms is generating gaps in transmissions from a given vessel is a critical task in using AIS to monitor vessels. Moreover, separating saturation and equipment issues from intentional disabling is a useful task in risk identification of IUU associated behaviour. Using this information on loitering behaviour and gaps in transmission, we identify and rank vessels which appear to be acting anomalously, with a focus on identifying potential IUU related activities. This information, combined with other sources of data, could help support enforcement agencies to implement international strategies such as the Port State Measures Agreement. A global list of such vessels and historical evidence of anomalous behaviour, would increase local powers of protection and provide one more step toward transparency within global fisheries.

  12. Decision Points and Considerations for Identifying Rural Districts That Have Closed Student Achievement Gaps. REL 2016-130

    ERIC Educational Resources Information Center

    Culbertson, Michael J.; Billig, Shelley H.

    2016-01-01

    Rural districts have long faced challenges in closing achievement gaps between subgroups of students. This brief report describes key decision points and considerations for decision-makers interested in identifying rural districts that have closed academic achievement gaps. Examining practices in these districts may suggest activities associated…

  13. Identifying Knowledge Gaps in Clinicians Who Evaluate and Treat Vocal Performing Artists in College Health Settings.

    PubMed

    McKinnon-Howe, Leah; Dowdall, Jayme

    2018-05-01

    The goal of this study was to identify knowledge gaps in clinicians who evaluate and treat performing artists for illnesses and injuries that affect vocal function in college health settings. This pilot study utilized a web-based cross-sectional survey design incorporating common clinical scenarios to test knowledge of evaluation and management strategies in the vocal performing artist. A web-based survey was administered to a purposive sample of 28 clinicians to identify the approach utilized to evaluate and treat vocal performing artists in college health settings, and factors that might affect knowledge gaps and influence referral patterns to voice specialists. Twenty-eight clinicians were surveyed, with 36% of respondents incorrectly identifying appropriate vocal hygiene measures, 56% of respondents failing to identify symptoms of vocal fold hemorrhage, 84% failing to identify other indications for referral to a voice specialist, 96% of respondents acknowledging unfamiliarity with the Voice Handicap Index and the Singers Voice Handicap Index, and 68% acknowledging unfamiliarity with the Reflux Symptom Index. The data elucidated specific knowledge gaps in college health providers who are responsible for evaluating and treating common illnesses that affect vocal function, and triaging and referring students experiencing symptoms of potential vocal emergencies. Future work is needed to improve the standard of care for this population. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  14. Simulation-based assessment to identify critical gaps in safe anesthesia resident performance.

    PubMed

    Blum, Richard H; Boulet, John R; Cooper, Jeffrey B; Muret-Wagstaff, Sharon L

    2014-01-01

    Valid methods are needed to identify anesthesia resident performance gaps early in training. However, many assessment tools in medicine have not been properly validated. The authors designed and tested use of a behaviorally anchored scale, as part of a multiscenario simulation-based assessment system, to identify high- and low-performing residents with regard to domains of greatest concern to expert anesthesiology faculty. An expert faculty panel derived five key behavioral domains of interest by using a Delphi process (1) Synthesizes information to formulate a clear anesthetic plan; (2) Implements a plan based on changing conditions; (3) Demonstrates effective interpersonal and communication skills with patients and staff; (4) Identifies ways to improve performance; and (5) Recognizes own limits. Seven simulation scenarios spanning pre-to-postoperative encounters were used to assess performances of 22 first-year residents and 8 fellows from two institutions. Two of 10 trained faculty raters blinded to trainee program and training level scored each performance independently by using a behaviorally anchored rating scale. Residents, fellows, facilitators, and raters completed surveys. Evidence supporting the reliability and validity of the assessment scores was procured, including a high generalizability coefficient (ρ = 0.81) and expected performance differences between first-year resident and fellow participants. A majority of trainees, facilitators, and raters judged the assessment to be useful, realistic, and representative of critical skills required for safe practice. The study provides initial evidence to support the validity of a simulation-based performance assessment system for identifying critical gaps in safe anesthesia resident performance early in training.

  15. 31 CFR 30.3 - Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance with this part? 30.3 Section 30.3 Money and... GOVERNANCE § 30.3 Q-3: How are the SEOs and most highly compensated employees identified for purposes of...

  16. 31 CFR 30.3 - Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance with this part? 30.3 Section 30.3 Money and... GOVERNANCE § 30.3 Q-3: How are the SEOs and most highly compensated employees identified for purposes of...

  17. 31 CFR 30.3 - Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance with this part? 30.3 Section 30.3 Money and... GOVERNANCE § 30.3 Q-3: How are the SEOs and most highly compensated employees identified for purposes of...

  18. 31 CFR 30.3 - Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance with this part? 30.3 Section 30.3 Money and... GOVERNANCE § 30.3 Q-3: How are the SEOs and most highly compensated employees identified for purposes of...

  19. Opinions of community pharmacists on the value of a cardiovascular polypill as a means of improving medication compliance.

    PubMed

    Burns, Kharis; Turnbull, Fiona; Patel, Anushka; Peiris, David

    2012-06-01

    Cardiovascular disease is a major public health problem despite established treatment guidelines and significant healthcare expenditure worldwide. Poor medication compliance accounts in part for some of the observed evidence/practice gaps. Trials of fixed-dose combination pills are currently underway, but the attitudes of relevant health professionals to the routine use of a cardiovascular polypill are generally unknown. Pharmacists are a group of providers who play an important role in patient compliance with long-term medications. The objective was to identify the main perceived barriers to compliance and to investigate pharmacists' opinions regarding the routine use of a cardiovascular polypill. The setting was community pharmacies in the metropolitan and greater areas of New South Wales, Australia. Structured questionnaires were administered to a random sample of community pharmacists and peer-to-peer, semi-structured interviews were conducted with a sub-sample. Quantitative data were analysed using SPSS V16.0 and interviews were analysed thematically. Questionnaires were completed by 72 of the 250 pharmacists invited to participate. The major barrier to cardiovascular medication compliance identified by respondents was polypharmacy. Other barriers included patient disinterest, time constraints and costs. Most pharmacists agreed that a cardiovascular polypill could be one potential solution to poor compliance by simplifying the treatment regimen (73.6% agreed) and reducing patient costs (79.2% agreed). Inability to tailor treatment and to ascribe side effects was among some of the identified concerns. The use of a cardiovascular polypill as a means of increasing patient compliance with long-term cardiovascular preventive therapies is seen as potentially valuable by community pharmacists. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

  20. 40 CFR 52.1425 - Compliance schedules.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Compliance schedules. 52.1425 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Nebraska § 52.1425 Compliance schedules. (a) The compliance schedules for the sources identified below are approved as revisions to the plan...

  1. 40 CFR 52.1335 - Compliance schedules.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Compliance schedules. 52.1335 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Missouri § 52.1335 Compliance schedules. (a) The compliance schedule for the source identified below is approved as a revision to the plan pursuant...

  2. Towards setting credible speed limits: Identifying factors that affect driver compliance on urban roads.

    PubMed

    Gargoum, Suliman A; El-Basyouny, Karim; Kim, Amy

    2016-10-01

    Road geometry, vehicle characteristics, and weather conditions are all factors that impact a driver's perception of a safe or credible speed and, consequently, the driver's decision on whether or not to comply with the posted speed limit. In fact, the role a road's environment plays in a driver's perception of a credible speed limit is a topic that has attracted the interest of many researchers in recent years. Despite that, not many studies have considered using empirical data to investigate what features of the road environment influence a driver's compliance choice. This paper aims to address this matter by exploring the relationships between features of the road surroundings (geometric, temporal factors, and weather conditions) and driver compliance with speed limits. The paper uses data from almost 600 different urban roads in the city of Edmonton, at which over 35 million vehicle spot speeds were collected. Compliance was represented using a categorical ordered response variable, and mixed-effects-logistic-regression models were fitted. Two different models were built, one for arterials and another for collector roads. In general, the findings show that the more restricted drivers become, particularly on arterials, the more likely drivers are to comply with speed limits; potential restrictions include on-street parking and the absence of lateral shoulders. Furthermore, higher traffic activity during peak hours, and presumably on shoulder weekdays, both increase the likelihood of compliance on arterials. Similarly, posted speed limits and traffic volume are both positively correlated with compliance on both arterial and collector roads. The findings of this research provide evidence of the existence of an empirical relationship between road features and compliance, highlighting the importance of setting credible speed limits on roads and the possibility of achieving higher compliance rates through modifications to the road environment. Copyright © 2016

  3. Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation.

    PubMed

    Ratwani, Raj; Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

    2016-11-16

    Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders' perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.

  4. Harmonization of European laboratory response networks by implementing CWA 15793: use of a gap analysis and an "insider" exercise as tools.

    PubMed

    Sundqvist, Bo; Bengtsson, Ulrika Allard; Wisselink, Henk J; Peeters, Ben P H; van Rotterdam, Bart; Kampert, Evelien; Bereczky, Sándor; Johan Olsson, N G; Szekely Björndal, Asa; Zini, Sylvie; Allix, Sébastien; Knutsson, Rickard

    2013-09-01

    Laboratory response networks (LRNs) have been established for security reasons in several countries including the Netherlands, France, and Sweden. LRNs function in these countries as a preparedness measure for a coordinated diagnostic response capability in case of a bioterrorism incident or other biocrimes. Generally, these LRNs are organized on a national level. The EU project AniBioThreat has identified the need for an integrated European LRN to strengthen preparedness against animal bioterrorism. One task of the AniBioThreat project is to suggest a plan to implement laboratory biorisk management CWA 15793:2011 (CWA 15793), a management system built on the principle of continual improvement through the Plan-Do-Check-Act (PDCA) cycle. The implementation of CWA 15793 can facilitate trust and credibility in a future European LRN and is an assurance that the work done at the laboratories is performed in a structured way with continuous improvements. As a first step, a gap analysis was performed to establish the current compliance status of biosafety and laboratory biosecurity management with CWA 15793 in 5 AniBioThreat partner institutes in France (ANSES), the Netherlands (CVI and RIVM), and Sweden (SMI and SVA). All 5 partners are national and/or international laboratory reference institutes in the field of public or animal health and possess high-containment laboratories and animal facilities. The gap analysis showed that the participating institutes already have robust biorisk management programs in place, but several gaps were identified that need to be addressed. Despite differences between the participating institutes in their compliance status, these variations are not significant. Biorisk management exercises also have been identified as a useful tool to control compliance status and thereby implementation of CWA 15793. An exercise concerning an insider threat and loss of a biological agent was performed at SVA in the AniBioThreat project to evaluate

  5. Identifying an Education Gap in Wound Care Training in United States Dermatology.

    PubMed

    Ruiz, Emily Stamell; Ingram, Amber; Landriscina, Angelo; Tian, Jiaying; Kirsner, Robert S; Friedman, Adam

    2015-07-01

    As restoration of the integument is paramount to wound healing, dermatologists should be central to managing wounds; yet this is often not the case. If a training gap exists during residency training, this may account for the observed discrepancy. To identify United States (US) dermatology residents' impressions regarding their preparedness to care for wounds, and to assess the amount and type of training devoted to wound care during residency. An online survey among current US dermatology residents enrolled in a residency training program. The primary goal was to determine whether dermatology residents believe more wound care education is needed, evaluate preparedness to care for wounds, and identify future plans to manage wounds. Responses were received from 175 of 517 (33.8%) US Dermatology residents contacted. The majority of residents did not feel prepared to manage acute (78.3%) and chronic (84.6%) wounds. Over three quarters (77.1%) felt that more education is needed. Fewer than half (49.1% and 35.4%) of residents planned to care for acute and chronic wounds, respectively, when in practice. There is a gap in wound care education in US dermatology residency training. This translates to a low percentage of dermatology residents planning to care for wounds in future practice. Dermatology residents need to receive focused wound care training in order to translate the underpinnings of wound healing biology and ultimately better serve patients.

  6. An Investigation to Validate the Grammar and Phonology Screening (GAPS) Test to Identify Children with Specific Language Impairment

    PubMed Central

    van der Lely, Heather K. J.; Payne, Elisabeth; McClelland, Alastair

    2011-01-01

    Background The extraordinarily high incidence of grammatical language impairments in developmental disorders suggests that this uniquely human cognitive function is “fragile”. Yet our understanding of the neurobiology of grammatical impairments is limited. Furthermore, there is no “gold-standard” to identify grammatical impairments and routine screening is not undertaken. An accurate screening test to identify grammatical abilities would serve the research, health and education communities, further our understanding of developmental disorders, and identify children who need remediation, many of whom are currently un-diagnosed. A potential realistic screening tool that could be widely administered is the Grammar and Phonology Screening (GAPS) test – a 10 minute test that can be administered by professionals and non-professionals alike. Here we provide a further step in evaluating the validity and accuracy (sensitivity and specificity) of the GAPS test in identifying children who have Specific Language Impairment (SLI). Methods and Findings We tested three groups of children; two groups aged 3;6–6:6, a typically developing (n = 30) group, and a group diagnosed with SLI: (n = 11) (Young (Y)-SLI), and a further group aged 6;9–8;11 with SLI (Older (O)-SLI) (n = 10) who were above the test age norms. We employed a battery of language assessments including the GAPS test to assess the children's language abilities. For Y-SLI children, analyses revealed a sensitivity and specificity at the 5th and 10th percentile of 1.00 and 0.98, respectively, and for O-SLI children at the 10th and 15th percentile .83 and .90, respectively. Conclusions The findings reveal that the GAPS is highly accurate in identifying impaired vs. non-impaired children up to 6;8 years, and has moderate-to-high accuracy up to 9 years. The results indicate that GAPS is a realistic tool for the early identification of grammatical abilities and impairment in young children. A larger

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

    PubMed Central

    Darbà, Josep; Ramírez, Gabriela; Sicras, Antoni; García-Bujalance, Laura; Torvinen, Saku; Sánchez-de la Rosa, Rainel

    2016-01-01

    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 exacerbations during the study period were more likely to comply with their medication regime. The effects of DPIs toward compliance varied with the different DPIs. For instance, Accuhaler® had a greater negative effect on compliance compared to Turbuhaler® and Nexthaler® in cases of patients who suffered exacerbations. We found that GP consultations reduced the probability of medication compliance for patients treated with formoterol/budesonide combination. For retired patients, visiting the GP increased the

  8. Improving the Pharmacologic Management of Pain in Older Adults: Identifying the Research Gaps and Methods to Address Them

    PubMed Central

    Reid, M. C.; Bennett, David A.; Chen, Wen G.; Eldadah, Basil A.; Farrar, John T.; Ferrell, Bruce; Gallagher, Rollin M.; Hanlon, Joseph T.; Herr, Keela; Horn, Susan D.; Inturrisi, Charles E.; Lemtouni, Salma; Lin, Yu Woody; Michaud, Kaleb; Morrison, R. Sean; Neogi, Tuhina; Porter, Linda L.; Solomon, Daniel H.; Von Korff, Michael; Weiss, Karen; Witter, James; Zacharoff, Kevin L.

    2011-01-01

    Objective There has been a growing recognition of the need for better pharmacologic management of chronic pain among older adults. To address this need, the National Institutes of Health Pain Consortium sponsored an “Expert Panel Discussion on the Pharmacological Management of Chronic Pain in Older Adults” conference in September, 2010, to identify research gaps and strategies to address them. Specific emphasis was placed on ascertaining gaps regarding use of opioid and non-steroidal anti-inflammatory medications because of continued uncertainties regarding their risks and benefits. Design Eighteen panel members provided oral presentations; each was followed by a multidisciplinary panel discussion. Meeting transcripts and panelists’ slide presentations were reviewed to identify the gaps, and the types of studies and research methods panelists suggested could best address them. Results Fifteen gaps were identified in the areas of treatment(e.g., uncertainty regarding the long-term safety and efficacy of commonly prescribed analgesics), epidemiology (e.g., lack of knowledge regarding the course of common pain syndromes), and implementation(e.g., limited understanding of optimal strategies to translate evidence-based pain treatments into practice). Analyses of data from electronic health care databases, observational cohort studies, and ongoing cohort studies (augmented with pain and other relevant outcomes measures) were felt to be practical methods for building an age-appropriate evidence base to improve the pharmacologic management of pain in later life. Conclusions Addressing the gaps presented in the current report was judged by the panel to have substantial potential to improve the health and well being of older adults with chronic pain. PMID:21834914

  9. Setting Priorities for Diabetic Retinopathy Clinical Research and Identifying Evidence Gaps.

    PubMed

    Le, Jimmy T; Hutfless, Susan; Li, Tianjing; Bressler, Neil M; Heyward, James; Bittner, Ava K; Glassman, Adam; Dickersin, Kay

    2017-01-01

    Prioritizing comparative effectiveness research may contribute to obtaining answers that clinicians perceive they need and may minimize research that could be considered wasteful. Our objective was to identify evidence gaps and set priorities for new systematic reviews and randomized controlled trials for managing diabetic retinopathy (DR), including diabetic macular edema (DME). Cross-sectional study. Diabetic Retinopathy Clinical Research Network (DRCR.net) investigators. We provided recommendations from the American Academy of Ophthalmology's 2012 Preferred Practice Patterns for Diabetic Retinopathy as 91 answerable clinical research questions about intervention effectiveness to 410 DRCR.net investigators to rate each question's importance from 0 (not important) to 10 (very important) using a 2-round Delphi survey and to suggest additional questions. We considered questions as high priority if at least 75% of respondents to both rounds assigned an importance rating of 5 or more in round 2. We also extracted outcome measures relevant to DR and asked respondents to identify those that must be measured in all studies. We mapped Cochrane reviews published up to March 2016 to high-priority clinical research questions. Ranking of importance of each clinical question. Thirty-two individuals completed rounds 1 and 2 and suggested 15 questions. Among the final list of 106 clinical research questions, 22 questions met our definition of high priority: 9 of 22 concerned the effectiveness of anti-VEGF therapy, and 13 of 22 focused on how often patients should be followed up (re-examination) and treatment effectiveness in patients with specific characteristics (e.g., DME). Outcomes that 75% or more of respondents marked as "must be measured in all studies" included visual acuity and visual loss, death of participants, and intraocular pressure. Only 1 prioritized question was associated with conclusive evidence from a Cochrane systematic review. A limited response rate among

  10. 31 CFR 30.3 - Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Q-3: How are the SEOs and most highly compensated employees identified for purposes of compliance with this part? 30.3 Section 30.3 Money and Finance: Treasury Office of the Secretary of the Treasury TARP STANDARDS FOR COMPENSATION AND CORPORATE...

  11. [Schools meals in French secondary state schools: compliance to national recommendations and schools catering patterns].

    PubMed

    Bertin, M; Lafay, L; Calamassi-Tran, G; Volatier, J-L; Dubuisson, C

    2011-02-01

    Recent reports on the lack of nutritional quality of meals served in schools have led public authorities to draft, in 1999, recommendations for restoring a balanced food supply. Following the survey carried out by the French food safety Agency in 2005-2006, which highlighted gaps in the implementation of these recommendations, a law passed in July 2010 plans to make these recommendations mandatory, as their 2007 revised version. Thus, the objective of this study was to assess initial school compliance with regard to this last revised version of the recommendations and to identify school patterns through their catering management and implication in a dietary project. Seven hundred and seven secondary state schools were questioned (570 were administrated by the Ministry of Education and 137 by the Ministry of Agriculture) on their catering practices. Twenty consecutive menus from each school were also analyzed with a specific coding system to establish its nutritional composition for comparison with the 2007 recommendations. On average, schools complied with half of the recommendations. Good compliance was observed with the 2007 recommendations concerning fried products, starchy foods, fruits, and dairy products whereas very few schools were in compliance with recommendations concerning fish, cheeses and sweetened desserts containing less than 15 % fat and more than 20 g of sugar per portion. Furthermore, compliance with recommendations was significantly better for lunch meals, and even better for agricultural establishments. A 5-component meal was also associated with greater compliance with the recommendations. In addition, four school patterns were identified based on catering management practices. The first two categories of establishments had knowledge of the recommendations but exhibited different levels of application. The last two types of establishments had no knowledge of the recommendations and differed in their catering management practices. Compliance

  12. The Apollo Accreditation Program: A web-based Joint Commission International standards compliance management tool.

    PubMed

    Dewan, Shaveta; Sibal, Anupam; Uberoi, R S; Kaur, Ishneet; Nayak, Yogamaya; Kar, Sujoy; Loria, Gaurav; Yatheesh, G; Balaji, V

    2014-01-01

    Creating and implementing processes to deliver quality care in compliance with accreditation standards is a challenging task but even more daunting is sustaining these processes and systems. There is need for frequent monitoring of the gap between the expected level of care and the level of care actually delivered so as to achieve consistent level of care. The Apollo Accreditation Program (AAP) was implemented as a web-based single measurable dashboard to display, measure and compare compliance levels for established standards of care in JCI accredited hospitals every quarter and resulted in an overall 15.5% improvement in compliance levels over one year.

  13. Using a research framework to identify knowledge gaps in research on food marketing to children in Australia.

    PubMed

    Chapman, Kathy; Kelly, Bridget; King, Lesley

    2009-06-01

    Research in the field of food marketing to children requires a better understanding of the research gaps in order to inform policy development. The purpose of this paper was to propose a framework for classifying food marketing research, using Australian research on food marketing to children to demonstrate how this framework can be used to determine knowledge gaps. A literature review of research databases and 'grey' material was conducted to identify research from the previous 10 years. Studies were classified according to their research focus, and media type, as either: exposure, including content analyses; effects of exposure, including opinions, attitudes and actions resulting from food marketing exposure; regulations, including the type and level of regulation that applies to food marketing; or breaches of regulations, including instances where marketing regulations have been violated. The majority of Australian research on food marketing to children has focused on television advertising and exposure research. Research has consistently shown that the content of food marketing directed at children is predominately for unhealthy foods. There is a lack of research on the effects of food marketing, which would be valuable to inform policy. The development of a logical framework for food marketing research allows for the identification of research gaps and enables research priorities to be identified.

  14. Validity and reliability of the Questionnaire for Compliance with Standard Precaution

    PubMed Central

    Valim, Marília Duarte; Marziale, Maria Helena Palucci; Hayashida, Miyeko; Rocha, Fernanda Ludmilla Rossi; Santos, Jair Lício Ferreira

    2015-01-01

    ABSTRACT OBJECTIVE : To evaluate the validity and reliability of the Questionnaire for Compliance with Standard Precaution for nurses. METHODS : This methodological study was conducted with 121 nurses from health care facilities in Sao Paulo’s countryside, who were represented by two high-complexity and by three average-complexity health care facilities. Internal consistency was calculated using Cronbach’s alpha and stability was calculated by the intraclass correlation coefficient, through test-retest. Convergent, discriminant, and known-groups construct validity techniques were conducted. RESULTS : The questionnaire was found to be reliable (Cronbach’s alpha: 0.80; intraclass correlation coefficient: (0.97) In regards to the convergent and discriminant construct validity, strong correlation was found between compliance to standard precautions, the perception of a safe environment, and the smaller perception of obstacles to follow such precautions (r = 0.614 and r = 0.537, respectively). The nurses who were trained on the standard precautions and worked on the health care facilities of higher complexity were shown to comply more (p = 0.028 and p = 0.006, respectively). CONCLUSIONS : The Brazilian version of the Questionnaire for Compliance with Standard Precaution was shown to be valid and reliable. Further investigation must be conducted with nurse samples that are more representative of the Brazilian reality. The use of the questionnaire may support the creation of educational measures considering the possible gaps that can be identified, focusing on the workers’ health and on the patients’ safety. PMID:26759967

  15. Supporting the patient's role in guideline compliance: a controlled study.

    PubMed

    Rosenberg, Stephen N; Shnaiden, Tatiana L; Wegh, Arnold A; Juster, Iver A

    2008-11-01

    Clinical messages alerting physicians to gaps in the care of specific patients have been shown to increase compliance with evidence-based guidelines. This study sought to measure any additional impact on compliance when alerting messages also were sent to patients. For alerts that were generated by computerized clinical rules applied to claims, compliance was determined by subsequent claims evidence (eg, that recommended tests were performed). Compliance was measured in the baseline year and the study year for 4 study group employers (combined membership >100,000) that chose to add patient messaging in the study year, and 28 similar control group employers (combined membership >700,000) that maintained physician messaging but did not add patient messaging. The impact of patient messaging was assessed by comparing changes in compliance from baseline to study year in the 2 groups. Multiple logistic regression was used to control for differences between the groups. Because a given member or physician could receive multiple alerts, generalized estimating equations with clustering by patient and physician were used. Controlling for differences in age, sex, and the severity and types of clinical alerts between the study and control groups, the addition of patient messaging increased compliance by 12.5% (P <.001). This increase was primarily because of improved responses to alerts regarding the need for screening, diagnostic, and monitoring tests. Supplementing clinical alerts to physicians with messages directly to their patients produced a statistically significant increase in compliance with the evidence-based guidelines underlying the alerts.

  16. Research gaps identified during systematic reviews of clinical trials: glass-ionomer cements.

    PubMed

    Mickenautsch, Steffen

    2012-06-29

    To report the results of an audit concerning research gaps in clinical trials that were accepted for appraisal in authored and published systematic reviews regarding the application of glass-ionomer cements (GIC) in dental practice Information concerning research gaps in trial precision was extracted, following a framework that included classification of the research gap reasons: 'imprecision of information (results)', 'biased information', 'inconsistency or unknown consistency' and 'not the right information', as well as research gap characterization using PICOS elements: population (P), intervention (I), comparison (C), outcomes (O) and setting (S). Internal trial validity assessment was based on the understanding that successful control for systematic error cannot be assured on the basis of inclusion of adequate methods alone, but also requires empirical evidence about whether such attempt was successful. A comprehensive and interconnected coverage of GIC-related clinical topics was established. The most common reasons found for gaps in trial precision were lack of sufficient trials and lack of sufficient large sample size. Only a few research gaps were ascribed to 'Lack of information' caused by focus on mainly surrogate trial outcomes. According to the chosen assessment criteria, a lack of adequate randomisation, allocation concealment and blinding/masking in trials covering all reviewed GIC topics was noted (selection- and detection/performance bias risk). Trial results appear to be less affected by loss-to-follow-up (attrition bias risk). This audit represents an adjunct of the systematic review articles it has covered. Its results do not change the systematic review's conclusions but highlight existing research gaps concerning the precision and internal validity of reviewed trials in detail. These gaps should be addressed in future GIC-related clinical research.

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

    PubMed

    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)

  18. Disease management and medication compliance.

    PubMed

    Cohen, Joshua; Christensen, Kathyrn; Feldman, Lanna

    2012-02-01

    Lack of medication compliance is harmful to health care systems from both a clinical and economic perspective. This study examines the methods that disease management organizations employ to identify nonadherent patients and to measure effectiveness of compliance programs for patients with diabetes, hyperlipidemia, and cystic fibrosis. In addition, this study investigates the degree to which disease managers assume risk in their contracts, and whether compliance strategies are being coordinated with payers' use of value-based insurance design, in which patient cost sharing is a function of the relative value of pharmaceuticals. This study's findings suggest that disease management may be falling short in terms of: (a) comprehensive commitment to expert-recommended at-home devices used to self-diagnose and measure health indicators; (b) early adoption of expert-recommended new technologies to measure and improve compliance; (c) intensity of use of standard tests in outpatient clinics; (d) coordination of compliance strategies with payers' use of value-based insurance design; and (e) the proportion of risk assumed in disease management contracts.

  19. Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit.

    PubMed

    Zaver, Fareen; Battaglioli, Nicole; Denq, William; Messman, Anne; Chung, Arlene; Lin, Michelle; Liu, Emberlynn L

    2018-03-01

    Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS) focused on wellness program innovations and initiatives in emergency medicine (EM) residency programs. Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, resident community consisting of 142 residents from 100 EM residencies in North America. A 15-person subgroup (13 residents, two faculty facilitators) met at the RWCS to develop a public, central repository of initiatives for programs, as well as tools to assist programs in identifying gaps in their overarching wellness programs. An online submission form and central database of wellness initiatives were created and accessible to the public. Wellness Think Tank members collected an initial 36 submissions for the database by the time of the RWCS event. Based on general workplace, needs-assessment tools on employee wellbeing and Kern's model for curriculum development, a resident-based needs-assessment survey and an implementation worksheet were created to assist residency programs in wellness program development. The Programmatic Initiatives workgroup from the resident-driven RWCS event created tools to assist EM residency programs in identifying existing initiatives and gaps in their wellness programs to meet the ACGME's expanded focus on resident wellbeing.

  20. Management bundles for candidaemia: the impact of compliance on clinical outcomes

    PubMed Central

    Takesue, Yoshio; Ueda, Takashi; Mikamo, Hiroshige; Oda, Shigeto; Takakura, Shunji; Kitagawa, Yuko; Kohno, Shigeru; Masuda, A.; Yoshida, C.; Yasunaga, C.; Yamashita, C.; Nakataki, E.; Ohyagi, H.; Yagi, H.; Johnai, H.; Murai, H.; Hanamoto, H.; Nakamura, I.; Sanada, I.; Tandai, I.; Kuroki, J.; Ogawa, J.; Kawahara, K.; Amino, K.; Nakajima, K.; Yoshimoto, K.; Takeda, K.; Nakamura, K.; Suzuki, K.; Yamada, K.; Aizawa, M.; Hashimoto, M.; Ogata, M.; Shirano, M.; Kawada, M.; Kaneda, M.; Yoshioka, M.; Okuda, N.; Sugita, N.; Kikuchi, N.; Fuke, S.; Tsuchihashi, S.; Sugitani, S.; Ikuta, S.; Honda, S.; Nei, T.; Iwamura, T.; Yagi, T.; Kaji, T.; Ichimiya, Y.; Kobayashi, Y.; Minamishima, Y.; Goto, Y.; Hatano, Y.; Nagao, Y.; Yamagishi, Y.; Sashihara, J.; Tsukamoto, A.; Kawaoka, T.; Kobayashi, M.

    2015-01-01

    Objectives The Mycoses Forum in Japan has developed management bundles for candidaemia to incorporate into bedside practice. The aim of this study was to investigate nationwide compliance with the bundles and their impact on clinical outcomes. Methods Non-neutropenic patients treated with antifungals for candidaemia were surveyed. Bundles consist of nine items to complete. Data were sent to the central office between July 2011 and April 2012. Results Six hundred and eight patients were analysed. The compliance rate for achieving all elements was 6.9%, and it increased to 21.4% when compliance was analysed by the bundle except for oral switch. There was a significant difference in clinical success between patients with and without compliance [92.9% versus 75.8% (P = 0.011)]. Compliance with the bundles, however, failed to be an independent factor associated with favourable outcomes. When step-down oral therapy was excluded from the elements of compliance, compliance with the bundles was revealed to be an independent predictor of clinical success (OR 4.42, 95% CI 2.05–9.52) and mortality (OR 0.27, 95% CI 0.13–0.57). Independent individual elements contributing to clinical success were removal of central venous catheters within 24 h, assessment of clinical efficacy on the third to the fifth day and at least 2 weeks of therapy after clearance of candidaemia. Conclusions Compliance with the bundles for candidaemia had a beneficial effect on clinical outcomes. Promotion of the bundles approach may have the potential to narrow the gap between clinical evidence and bedside practice. PMID:25326087

  1. [Identifying gaps between guidelines and clinical practice in Clostridium difficile infection].

    PubMed

    Rodríguez-Martín, C; Serrano-Morte, A; Sánchez-Muñoz, L A; de Santos-Castro, P A; Bratos-Pérez, M A; Ortiz de Lejarazu-Leonardo, R

    2016-01-01

    The first aim was to determine whether patients are being treated in accordance with the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America (IDSA/SHEA) Clostridium difficile guidelines and whether adherence impacts patient outcomes. The second aim was to identify specific action items in the guidelines that are not being translated into clinical practice, for their subsequent implementation. A retrospective, descriptive study was conducted over a 36 month period, on patients with compatible clinical symptoms and positive test for C. difficile toxins A and/or B in stool samples, in an internal medicine department of a tertiary medical centre. Patient demographic and clinical data (outcomes, comorbidity, risk factors) and compliance with guidelines, were examined A total of 77 patients with C. difficile infection were identified (87 episodes). Stratified by disease severity criteria, 49.3% of patients were mild-moderate, 35.1% severe, and 15.6% severe-complicated. Full adherence with the guidelines was observed in only 40.2% of patients, and was significantly better for mild-moderate (71.0%), than in severe (7.4%) or severe-complicated patients (16.6%) (P<.003). Adherence was significantly associated with clinical cure (57% vs 42%), fewer recurrences (22.2% vs 77.7%), and mortality (25% vs 75%) (P<.01). The stratification of severity of the episode, and the adequacy of antibiotic to clinical severity, need improvement. Overall adherence with the guidelines for management of Clostridium difficile infection was poor, especially in severe and severe-complicated patients, being associated with worse clinical outcomes. Educational interventions aimed at improving guideline adherence are warranted. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  2. Compliance monitoring in business processes: Functionalities, application, and tool-support.

    PubMed

    Ly, Linh Thao; Maggi, Fabrizio Maria; Montali, Marco; Rinderle-Ma, Stefanie; van der Aalst, Wil M P

    2015-12-01

    In recent years, monitoring the compliance of business processes with relevant regulations, constraints, and rules during runtime has evolved as major concern in literature and practice. Monitoring not only refers to continuously observing possible compliance violations, but also includes the ability to provide fine-grained feedback and to predict possible compliance violations in the future. The body of literature on business process compliance is large and approaches specifically addressing process monitoring are hard to identify. Moreover, proper means for the systematic comparison of these approaches are missing. Hence, it is unclear which approaches are suitable for particular scenarios. The goal of this paper is to define a framework for Compliance Monitoring Functionalities (CMF) that enables the systematic comparison of existing and new approaches for monitoring compliance rules over business processes during runtime. To define the scope of the framework, at first, related areas are identified and discussed. The CMFs are harvested based on a systematic literature review and five selected case studies. The appropriateness of the selection of CMFs is demonstrated in two ways: (a) a systematic comparison with pattern-based compliance approaches and (b) a classification of existing compliance monitoring approaches using the CMFs. Moreover, the application of the CMFs is showcased using three existing tools that are applied to two realistic data sets. Overall, the CMF framework provides powerful means to position existing and future compliance monitoring approaches.

  3. Treatment Compliance in Group Therapy: Issues and Interventions

    ERIC Educational Resources Information Center

    Hunnicutt Hollenbaugh, Karen Michelle

    2011-01-01

    In this manuscript, research on treatment compliance and dropout in group therapy is reviewed. A number of variables found to be related to the compliance and dropout are identified including client characteristics, treatment characteristics, and therapist perceptions and behavior. Implications of these results for increasing treatment compliance…

  4. Compliance as a prognostic indicator. II. Impact of patient's compliance to the individual tooth survival.

    PubMed

    Miyamoto, Takanari; Kumagai, Takashi; Lang, Melissa S; Nunn, Martha E

    2010-09-01

    Existing evidence concerning the validity of an appropriate regular periodontal maintenance (PM) regimen and the role of patient compliance is controversial and inconsistent. The objectives of this study are to identify the impact of patient compliance (complete versus erratic) on alveolar bone loss and tooth survival. A retrospective study was conducted using data from 295 patients with >or=20 years of observation, which included treatment and >or=15 years of maintenance therapy, in a private practice in Yamagata, Japan. Subject-level variables and tooth-level variables were recorded at the initial visit, the reevaluation visit, and the final visit. In total, 7,502 teeth in 295 subjects met inclusion criteria and were divided into two groups: non-molar teeth (n = 5,585) and molar teeth (n = 1,917). A tooth-level multivariate survival model and multiple logistic regression model using the method of generalized estimating equations were constructed to analyze the effects of compliance and periodontal maintenance intervals on tooth loss and alveolar bone loss, respectively. Of 7,502 teeth, 284 molar teeth and 364 non-molar teeth were lost. Molar teeth had an approximately 30% reduction in risk of tooth loss for complete compliance, with 2-year compliance classification achieving statistical significance (P = 0.033), and 30% compliance classification approaching statistical significance (P = 0.072). Complete compliers under 30% compliance classification showed over 50% reduction in the risk of alveolar bone loss among non-molars (P = 0.015). Complete patient compliance with increased frequency of periodontal maintenance is important for improved dental prognosis through reduction of tooth loss among molars and minimization of alveolar bone loss among non-molars.

  5. Evolving Patient Compliance Trends: Integrating Clinical, Insurance, and Extrapolated Socioeconomic Data

    PubMed Central

    Klobusicky, Joseph J.; Aryasomayajula, Arun; Marko, Nicholas

    2015-01-01

    Efforts toward improving patient compliance in medication focus on either identifying trends in patient features or studying changes through an intervention. Our study seeks to provide an important link between these two approaches through defining trends of evolving compliance. In addition to using clinical covariates provided through insurance claims and health records, we also extracted census based data to provide socioeconomic covariates such as income and population density. Through creating quadrants based on periods of medicine intake, we derive several novel definitions of compliance. These definitions revealed additional compliance trends through considering refill histories later in a patient’s length of therapy. These results suggested that the link between patient features and compliance includes a temporal component, and should be considered in policymaking when identifying compliant subgroups. PMID:26958212

  6. Gap Resolution

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Labutti, Kurt; Foster, Brian; Lapidus, Alla

    Gap Resolution is a software package that was developed to improve Newbler genome assemblies by automating the closure of sequence gaps caused by repetitive regions in the DNA. This is done by performing the follow steps:1) Identify and distribute the data for each gap in sub-projects. 2) Assemble the data associated with each sub-project using a secondary assembler, such as Newbler or PGA. 3) Determine if any gaps are closed after reassembly, and either design fakes (consensus of closed gap) for those that closed or lab experiments for those that require additional data. The software requires as input a genomemore » assembly produce by the Newbler assembler provided by Roche and 454 data containing paired-end reads.« less

  7. Using fault tree analysis to identify causes of non-compliance: enhancing violation outcome data for the purposes of education and prevention.

    PubMed

    Emery, R J; Charlton, M A; Orders, A B; Hernandez, M

    2001-02-01

    An enhanced coding system for the characterization of notices of violation (NOV's) issued to radiation permit holders in the State of Texas was developed based on a series of fault tree analyses serving to identify a set of common causes. The coding system enhancement was retroactively applied to a representative sample (n = 185) of NOV's issued to specific licensees of radioactive materials in Texas during calendar year 1999. The results obtained were then compared to the currently available summary NOV information for the same year. In addition to identifying the most common NOV's, the enhanced coding system revealed that approximately 70% of the sampled NOV's were issued for non-compliance with a specific regulation as opposed to a permit condition. Furthermore, an underlying cause of 94% of the NOV's was the failure on the part of the licensee to execute a specific task. The findings suggest that opportunities exist to improve permit holder compliance through various means, including the creation of summaries which detail specific tasks to be completed, and revising training programs with more focus on the identification and scheduling of permit-related requirements. Broad application of these results is cautioned due to the bias associated with the restricted scope of the project.

  8. Compliance with removable orthodontic appliances.

    PubMed

    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.

  9. Compliance monitoring in business processes: Functionalities, application, and tool-support

    PubMed Central

    Ly, Linh Thao; Maggi, Fabrizio Maria; Montali, Marco; Rinderle-Ma, Stefanie; van der Aalst, Wil M.P.

    2015-01-01

    In recent years, monitoring the compliance of business processes with relevant regulations, constraints, and rules during runtime has evolved as major concern in literature and practice. Monitoring not only refers to continuously observing possible compliance violations, but also includes the ability to provide fine-grained feedback and to predict possible compliance violations in the future. The body of literature on business process compliance is large and approaches specifically addressing process monitoring are hard to identify. Moreover, proper means for the systematic comparison of these approaches are missing. Hence, it is unclear which approaches are suitable for particular scenarios. The goal of this paper is to define a framework for Compliance Monitoring Functionalities (CMF) that enables the systematic comparison of existing and new approaches for monitoring compliance rules over business processes during runtime. To define the scope of the framework, at first, related areas are identified and discussed. The CMFs are harvested based on a systematic literature review and five selected case studies. The appropriateness of the selection of CMFs is demonstrated in two ways: (a) a systematic comparison with pattern-based compliance approaches and (b) a classification of existing compliance monitoring approaches using the CMFs. Moreover, the application of the CMFs is showcased using three existing tools that are applied to two realistic data sets. Overall, the CMF framework provides powerful means to position existing and future compliance monitoring approaches. PMID:26635430

  10. Compliance with universal precautions in correctional health care facilities.

    PubMed

    Gershon, R R; Karkashian, C D; Vlahov, D; Kummer, L; Kasting, C; Green-McKenzie, J; Escamilla-Cejudo, J A; Kendig, N; Swetz, A; Martin, L

    1999-03-01

    There were three main objectives of this cross-sectional study of Maryland State correctional health care workers. The first was to evaluate compliance with work practices designed to minimize exposure to blood and body fluids; the second, to identify correlates of compliance with universal precautions (UPs); and the third was to determine the relationship, if any, between compliance and exposures. Of 216 responding health care workers, 34% reported overall compliance across all 15 items on a compliance scale. Rates for specific items were particularly low for use of certain types of personal protective equipment, such as protective eyewear (53.5%), face mask (47.2%) and protective clothing (33.9%). Compliance rates were highest for glove use (93.2%) waste disposal (89.8%), and sharps disposal (80.8%). Compliance rates were generally not associated with demographic factors, except for age; younger workers were more likely to be compliant with safe work practices than were older workers (P < 0.05). Compliance was positively associated with several work-related variables, including perceived safety climate (i.e., management's commitment to infection control and the overall safety program) and job satisfaction, and was found to be inversely associated with security-related work constraints, job/task factors, adverse working conditions, workplace discrimination, and perceived work stress. Bloodborne exposures were not uncommon; 13.8% of all respondents had at least one bloodborne exposure within the previous 6 months, and compliance was inversely related to blood and body fluid exposures. This study identified several potentially modifiable correlates of compliance, including factors unique to the correctional setting. Infection-control interventional strategies specifically tailored to these health care workers may therefore be most effective in reducing the risk of bloodborne exposures.

  11. A shipboard comparison of analytic methods for ballast water compliance monitoring

    NASA Astrophysics Data System (ADS)

    Bradie, Johanna; Broeg, Katja; Gianoli, Claudio; He, Jianjun; Heitmüller, Susanne; Curto, Alberto Lo; Nakata, Akiko; Rolke, Manfred; Schillak, Lothar; Stehouwer, Peter; Vanden Byllaardt, Julie; Veldhuis, Marcel; Welschmeyer, Nick; Younan, Lawrence; Zaake, André; Bailey, Sarah

    2018-03-01

    Promising approaches for indicative analysis of ballast water samples have been developed that require study in the field to examine their utility for determining compliance with the International Convention for the Control and Management of Ships' Ballast Water and Sediments. To address this gap, a voyage was undertaken on board the RV Meteor, sailing the North Atlantic Ocean from Mindelo (Cape Verde) to Hamburg (Germany) during June 4-15, 2015. Trials were conducted on local sea water taken up by the ship's ballast system at multiple locations along the trip, including open ocean, North Sea, and coastal water, to evaluate a number of analytic methods that measure the numeric concentration or biomass of viable organisms according to two size categories (≥ 50 μm in minimum dimension: 7 techniques, ≥ 10 μm and < 50 μm: 9 techniques). Water samples were analyzed in parallel to determine whether results were similar between methods and whether rapid, indicative methods offer comparable results to standard, time- and labor-intensive detailed methods (e.g. microscopy) and high-end scientific approaches (e.g. flow cytometry). Several promising indicative methods were identified that showed high correlation with microscopy, but allow much quicker processing and require less expert knowledge. This study is the first to concurrently use a large number of analytic tools to examine a variety of ballast water samples on board an operational ship in the field. Results are useful to identify the merits of each method and can serve as a basis for further improvement and development of tools and methodologies for ballast water compliance monitoring.

  12. Spinal Cord Injury Clinical Registries: Improving Care across the SCI Care Continuum by Identifying Knowledge Gaps.

    PubMed

    Dvorak, Marcel F; Cheng, Christiana L; Fallah, Nader; Santos, Argelio; Atkins, Derek; Humphreys, Suzanne; Rivers, Carly S; White, Barry A B; Ho, Chester; Ahn, Henry; Kwon, Brian K; Christie, Sean; Noonan, Vanessa K

    2017-10-15

    Timely access and ongoing delivery of care and therapeutic interventions is needed to maximize recovery and function after traumatic spinal cord injury (tSCI). To ensure these decisions are evidence-based, access to consistent, reliable, and valid sources of clinical data is required. The Access to Care and Timing Model used data from the Rick Hansen SCI Registry (RHSCIR) to generate a simulation of healthcare delivery for persons after tSCI and to test scenarios aimed at improving outcomes and reducing the economic burden of SCI. Through model development, we identified knowledge gaps and challenges in the literature and current health outcomes data collection throughout the continuum of SCI care. The objectives of this article were to describe these gaps and to provide recommendations for bridging them. Accurate information on injury severity after tSCI was hindered by difficulties in conducting neurological assessments and classifications of SCI (e.g., timing), variations in reporting, and the lack of a validated SCI-specific measure of associated injuries. There was also limited availability of reliable data on patient factors such as multi-morbidity and patient-reported measures. Knowledge gaps related to structures (e.g., protocols) and processes (e.g., costs) at each phase of care have prevented comprehensive evaluation of system performance. Addressing these knowledge gaps will enhance comparative and cost-effectiveness evaluations to inform decision-making and standards of care. Recommendations to do so were: standardize data element collection and facilitate database linkages, validate and adopt more outcome measures for SCI, and increase opportunities for collaborations with stakeholders from diverse backgrounds.

  13. Spinal Cord Injury Clinical Registries: Improving Care across the SCI Care Continuum by Identifying Knowledge Gaps

    PubMed Central

    Cheng, Christiana L.; Fallah, Nader; Santos, Argelio; Atkins, Derek; Humphreys, Suzanne; Rivers, Carly S.; White, Barry A.B.; Ho, Chester; Ahn, Henry; Kwon, Brian K.; Christie, Sean; Noonan, Vanessa K.

    2017-01-01

    Abstract Timely access and ongoing delivery of care and therapeutic interventions is needed to maximize recovery and function after traumatic spinal cord injury (tSCI). To ensure these decisions are evidence-based, access to consistent, reliable, and valid sources of clinical data is required. The Access to Care and Timing Model used data from the Rick Hansen SCI Registry (RHSCIR) to generate a simulation of healthcare delivery for persons after tSCI and to test scenarios aimed at improving outcomes and reducing the economic burden of SCI. Through model development, we identified knowledge gaps and challenges in the literature and current health outcomes data collection throughout the continuum of SCI care. The objectives of this article were to describe these gaps and to provide recommendations for bridging them. Accurate information on injury severity after tSCI was hindered by difficulties in conducting neurological assessments and classifications of SCI (e.g., timing), variations in reporting, and the lack of a validated SCI-specific measure of associated injuries. There was also limited availability of reliable data on patient factors such as multi-morbidity and patient-reported measures. Knowledge gaps related to structures (e.g., protocols) and processes (e.g., costs) at each phase of care have prevented comprehensive evaluation of system performance. Addressing these knowledge gaps will enhance comparative and cost-effectiveness evaluations to inform decision-making and standards of care. Recommendations to do so were: standardize data element collection and facilitate database linkages, validate and adopt more outcome measures for SCI, and increase opportunities for collaborations with stakeholders from diverse backgrounds. PMID:28745934

  14. Progress and Compliance in Alcohol Abuse Treatment*

    PubMed Central

    Lien, Hsien-Ming; Lu, Mingshan; Ma, Ching-To Albert; McGuire, Thomas G.

    2009-01-01

    Improving patient compliance with physicians’ treatment or prescription recommendations is an important goal in medical practice. We examine the relationship between treatment progress and patient compliance. We hypothesize that patients balance expected benefits and costs during a treatment episode when deciding on compliance; a patient is more likely to comply if doing so results in an expected gain in health benefit. We use a unique data set of outpatient alcohol abuse treatment to identify a relationship between treatment progress and compliance. Treatment progress is measured by the clinician’s comments after each attended visit. Compliance is measured by a client attending a scheduled appointment, and continuing with treatment. We find that a patient who is making progress is less likely to drop out of treatment. We find no evidence that treatment progress raises the likelihood of a patient attending the next scheduled visit. Our results are robust to unobserved patient heterogeneity. PMID:20031241

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

    PubMed Central

    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

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

    PubMed

    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.

  17. Mind the Gap

    PubMed Central

    Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

    2016-01-01

    Summary Objective Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders’ perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Materials and Methods Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders’ perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. Results We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical work-flow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Discussion Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Conclusion Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation. PMID:27847961

  18. Security practices and regulatory compliance in the healthcare industry.

    PubMed

    Kwon, Juhee; Johnson, M Eric

    2013-01-01

    Securing protected health information is a critical responsibility of every healthcare organization. We explore information security practices and identify practice patterns that are associated with improved regulatory compliance. We employed Ward's cluster analysis using minimum variance based on the adoption of security practices. Variance between organizations was measured using dichotomous data indicating the presence or absence of each security practice. Using t tests, we identified the relationships between the clusters of security practices and their regulatory compliance. We utilized the results from the Kroll/Healthcare Information and Management Systems Society telephone-based survey of 250 US healthcare organizations including adoption status of security practices, breach incidents, and perceived compliance levels on Health Information Technology for Economic and Clinical Health, Health Insurance Portability and Accountability Act, Red Flags rules, Centers for Medicare and Medicaid Services, and state laws governing patient information security. Our analysis identified three clusters (which we call leaders, followers, and laggers) based on the variance of security practice patterns. The clusters have significant differences among non-technical practices rather than technical practices, and the highest level of compliance was associated with hospitals that employed a balanced approach between technical and non-technical practices (or between one-off and cultural practices). Hospitals in the highest level of compliance were significantly managing third parties' breaches and training. Audit practices were important to those who scored in the middle of the pack on compliance. Our results provide security practice benchmarks for healthcare administrators and can help policy makers in developing strategic and practical guidelines for practice adoption.

  19. Security practices and regulatory compliance in the healthcare industry

    PubMed Central

    Kwon, Juhee; Johnson, M Eric

    2013-01-01

    Objective Securing protected health information is a critical responsibility of every healthcare organization. We explore information security practices and identify practice patterns that are associated with improved regulatory compliance. Design We employed Ward's cluster analysis using minimum variance based on the adoption of security practices. Variance between organizations was measured using dichotomous data indicating the presence or absence of each security practice. Using t tests, we identified the relationships between the clusters of security practices and their regulatory compliance. Measurement We utilized the results from the Kroll/Healthcare Information and Management Systems Society telephone-based survey of 250 US healthcare organizations including adoption status of security practices, breach incidents, and perceived compliance levels on Health Information Technology for Economic and Clinical Health, Health Insurance Portability and Accountability Act, Red Flags rules, Centers for Medicare and Medicaid Services, and state laws governing patient information security. Results Our analysis identified three clusters (which we call leaders, followers, and laggers) based on the variance of security practice patterns. The clusters have significant differences among non-technical practices rather than technical practices, and the highest level of compliance was associated with hospitals that employed a balanced approach between technical and non-technical practices (or between one-off and cultural practices). Conclusions Hospitals in the highest level of compliance were significantly managing third parties’ breaches and training. Audit practices were important to those who scored in the middle of the pack on compliance. Our results provide security practice benchmarks for healthcare administrators and can help policy makers in developing strategic and practical guidelines for practice adoption. PMID:22955497

  20. Safety compliance and safety climate: A repeated cross-sectional study in the oil and gas industry.

    PubMed

    Kvalheim, Sverre A; Dahl, Øyvind

    2016-12-01

    Violations of safety rules and procedures are commonly identified as a causal factor in accidents in the oil and gas industry. Extensive knowledge on effective management practices related to improved compliance with safety procedures is therefore needed. Previous studies of the causal relationship between safety climate and safety compliance demonstrate that the propensity to act in accordance with prevailing rules and procedures is influenced to a large degree by workers' safety climate. Commonly, the climate measures employed differ from one study to another and identical measures of safety climate are seldom tested repeatedly over extended periods of time. This research gap is addressed in the present study. The study is based on a survey conducted four times among sharp-end workers of the Norwegian oil and gas industry (N=31,350). This is done by performing multiple tests (regression analysis) over a period of 7years of the causal relationship between safety climate and safety compliance. The safety climate measure employed is identical across the 7-year period. Taking all periods together, the employed safety climate model explained roughly 27% of the variance in safety compliance. The causal relationship was found to be stable across the period, thereby increasing the reliability and the predictive validity of the factor structure. The safety climate factor that had the most powerful effect on safety compliance was work pressure. The factor structure employed shows high predictive validity and should therefore be relevant to organizations seeking to improve safety in the petroleum sector. The findings should also be relevant to other high-hazard industries where safety rules and procedures constitute a central part of the approach to managing safety. Copyright © 2016 Elsevier Ltd and National Safety Council. All rights reserved.

  1. GapBlaster-A Graphical Gap Filler for Prokaryote Genomes.

    PubMed

    de Sá, Pablo H C G; Miranda, Fábio; Veras, Adonney; de Melo, Diego Magalhães; Soares, Siomar; Pinheiro, Kenny; Guimarães, Luis; Azevedo, Vasco; Silva, Artur; Ramos, Rommel T J

    2016-01-01

    The advent of NGS (Next Generation Sequencing) technologies has resulted in an exponential increase in the number of complete genomes available in biological databases. This advance has allowed the development of several computational tools enabling analyses of large amounts of data in each of the various steps, from processing and quality filtering to gap filling and manual curation. The tools developed for gap closure are very useful as they result in more complete genomes, which will influence downstream analyses of genomic plasticity and comparative genomics. However, the gap filling step remains a challenge for genome assembly, often requiring manual intervention. Here, we present GapBlaster, a graphical application to evaluate and close gaps. GapBlaster was developed via Java programming language. The software uses contigs obtained in the assembly of the genome to perform an alignment against a draft of the genome/scaffold, using BLAST or Mummer to close gaps. Then, all identified alignments of contigs that extend through the gaps in the draft sequence are presented to the user for further evaluation via the GapBlaster graphical interface. GapBlaster presents significant results compared to other similar software and has the advantage of offering a graphical interface for manual curation of the gaps. GapBlaster program, the user guide and the test datasets are freely available at https://sourceforge.net/projects/gapblaster2015/. It requires Sun JDK 8 and Blast or Mummer.

  2. Full-scale regional exercises: closing the gaps in disaster preparedness.

    PubMed

    Klima, David A; Seiler, Sarah H; Peterson, Jeff B; Christmas, A Britton; Green, John M; Fleming, Greg; Thomason, Michael H; Sing, Ronald F

    2012-09-01

    Man-made (9/11) and natural (Hurricane Katrina) disasters have enlightened the medical community regarding the importance of disaster preparedness. In response to Joint Commission requirements, medical centers should have established protocols in place to respond to such events. We examined a full-scale regional exercise (FSRE) to identify gaps in logistics and operations during a simulated mass casualty incident. A multiagency, multijurisdictional, multidisciplinary exercise (FSRE) included 16 area hospitals and one American College of Surgeons-verified Level I trauma center (TC). The scenario simulated a train derailment and chemical spill 20 miles from the TC using 281 moulaged volunteers. Third-party contracted evaluators assessed each hospital in five areas: communications, command structure, decontamination, staffing, and patient tracking. Further analysis examined logistic and operational deficiencies. None of the 16 hospitals were compliant in all five areas. Mean hospital compliance was 1.9 (± 0.9 SD) areas. One hospital, unable to participate because of an air conditioner outage, was deemed 0% compliant. The most common deficiency was communications (15 of 16 hospitals [94%]; State Medical Asset Resource Tracking Tool system deficiencies, lack of working knowledge of Voice Interoperability Plan for Emergency Responders radio system) followed by deficient decontamination in 12 (75%). Other deficiencies included inadequate staffing based on predetermined protocols in 10 hospitals (63%), suboptimal command structure in 9 (56%), and patient tracking deficiencies in 5 (31%). An additional 11 operational and 5 logistic failures were identified. The TC showed an appropriate command structure but was deficient in four of five categories, with understaffing and a decontamination leak into the emergency department, which required diversion of 70 patients. Communication remains a significant gap in the mass casualty scenario 10 years after 9/11. Our findings

  3. SOUTHWEST REGIONAL GAP LAND COVER

    EPA Science Inventory

    The Gap Analysis Program is a national inter-agency program that maps the distribution

    of plant communities and selected animal species and compares these distributions with land

    stewardship to identify gaps in biodiversity protection. GAP uses remote satellite imag...

  4. Using Satellite Data to Identify the Causes of and Potential Solutions for Yield Gaps in India's Wheat Belt

    NASA Astrophysics Data System (ADS)

    Jain, M.; Singh, B.; Srivastava, A.; Malik, R. K.; McDonald, A.; Lobell, D. B.

    2017-12-01

    Food security will be increasingly challenged by climate change, natural resource degradation, and population growth. Wheat yields, in particular, have already stagnated in many regions and will be further affected by warming temperatures. Despite these challenges, wheat yields can be increased by improving management practices in regions with existing yield gaps. We present two studies that are using satellite data to better understand the factors contributing to yield gaps and potential interventions to close yield gaps in India's main wheat belt, the Indo-Gangetic Plains (IGP). To identify the magnitude and causes of current yield gaps, we produced 30 meter resolution yield maps from 2001 to 2015 using Landsat sallite data and a new method that translates satellite vegetation indices to yield estimates using crop model simulations, bypassing the need for ground calibration data. This is one of the first attempts to apply this method to a smallholder agriculture system, where ground calibration data are rarely available. We find that yields can be increased by 11% on average and up to 32% in the eastern IGP by improving management to current best practices within a given district. Additionally, if current best practices from the highest-yielding state of Punjab are implemented in the eastern IGP, yields could increase by almost 110%. Considering the factors that most influence yields, later sow dates and warmer temperatures are most associated with low yields across the IGP. This suggests that strategies to reduce the negative effects of heat stress, like earlier sowing and planting heat-tolerant wheat varieties, are critical to increasing wheat yields in this globally-important agricultural region. We also apply this method to high-resolution micro-satellite data (< 5 m) to map field and sub-field level yields across villages in Bihar in the eastern IGP. Using these data, we assess the impacts of a new fertilizer spreader technology and identify whether

  5. Environmental Compliance Assessment Management Program (ECAMP) - U.S. Fish and Wildlife Service (FWS)

    DTIC Science & Technology

    1994-06-01

    and Wildlife Service, began research on the Environmental Compliance Assessment and Management Program (ECAMP). The concept was to combine Code of ... The number of environmental laws and regulations have continued to grow in the United States and worldwide, making compliance with these regulations...Service has adopted an environmental compliance program that identifies compliance problems before they are cited as violations by the U.S

  6. A systematic review of compliance to oral nutritional supplements.

    PubMed

    Hubbard, Gary P; Elia, Marinos; Holdoway, Anne; Stratton, Rebecca J

    2012-06-01

    Oral nutritional supplements (ONS) play a key role in the management of malnutrition. This systematic review examined patients' compliance with ONS across healthcare settings and the influence of patient and ONS-related factors. A systematic review identified 46 studies (n = 4328) of ONS in which data on compliance (% of prescribed quantity of ONS consumed) was available. Pooled mean %compliance was assessed overall and according to study design and healthcare setting. Inter-relationships between compliance and ONS-related and patient-related factors, and total energy intake were assessed. Overall mean compliance with ONS was 78% (37%-100%; 67% hospital, 81% community; overall mean ONS intake 433 kcal/d). Percentage compliance was similar in randomised (79%) and non-randomised (77%) trials, with little variation between diagnostic groups. Compliance across a heterogeneous group of unmatched studies was positively associated with higher energy-density ONS and greater ONS and total energy intakes, negatively associated with age, and unrelated to amount or duration of ONS prescription. This systematic review suggests that compliance to ONS is good, especially with higher energy-density ONS, resulting in improvements in patients' total energy intakes that have been linked with clinical benefits. Further research is required to address the compliance and effectiveness of other common methods of oral nutritional support. Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  7. Evidence for compliance with long-term medication: a systematic review of randomised controlled trials.

    PubMed

    King, Michelle A; Pryce, Rebecca L

    2014-02-01

    Pharmacists play a pivotal role in optimising medication use which often includes actions to maximise compliance with long-term medication. The best evidence to support medication use is derived from randomised controlled trials (RCTs). It is often assumed that 100 % compliance is required to obtain the outcomes identified in the trial. This assumption needs to be examined. To systematically review the reporting of compliance in RCTs of long-term medications. RCTs published in the New England Journal of Medicine, Journal of the American Medical Association, Lancet and BMJ in 2012, were reviewed to identify trials of medications for long-term use in adults. These trials were examined to evaluate the reporting of compliance. The proportion of trials reporting compliance data, the methods used, and the proportion of trials using more than one method to determine compliance. Of the 289 RCTs published in 2012, 25 assessed long-term medications in adults. Compliance was reported in 12 (48 %) studies and only 2 (8 %) studies used more than one method to measure compliance. Pill count was the most commonly reported method for measuring compliance, with patient reports and blood levels also being used. The reporting of compliance in RCTs is poor and the methodology inconsistent. The methods used overestimate compliance. If compliance in a clinical trial is low, the evidence for the effectiveness and most importantly safety of the medication(s) is questionable. Two or more methods, one of which is standardised, should be used to measure compliance in clinical trials. The requirement to report compliance should be included in publication guidelines.

  8. Identifying gaps in conservation networks: of indicators and uncertainty in geographic-based analyses

    Treesearch

    Curtis H. Flather; Kenneth R. Wilson; Denis J. Dean; William C. McComb

    1997-01-01

    Mapping of biodiversity elements to expose gaps in. conservation networks has become a common strategy in nature-reserve design. We review a set of critical assumptions and issues that influence the interpretation and implementation of gap analysis, including: (1) the assumption that a subset of taxa can be used to indicate overall diversity patterns, and (2) the...

  9. Principals and School Counselors: Separate Entities in Identifying Achievement Gaps in College Readiness for African American Students With Disabilities

    ERIC Educational Resources Information Center

    Roberts, Laura A.; Bouknight, Tamisha M.

    2015-01-01

    This case illustrates an example of how one school relied solely on aggregate data and failed to address the college readiness needs of African American students with disabilities. However, the way in which the school counselor identified this opportunity gap may not have been the most ethical approach, and now she is faced with a dilemma. This…

  10. Compliance Verification Paths for Residential and Commercial Energy Codes

    DOE Office of Scientific and Technical Information (OSTI.GOV)

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

    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.

  11. Identifying the gaps: Armenian health care legislation and human rights in patient care protections.

    PubMed

    Zopunyan, Violeta; Krmoyan, Suren; Quinn, Ryan

    2013-12-12

    Since the collapse of the Soviet Union, the Republic of Armenia has undergone an extensive legislative overhaul. Although a number of developments have aimed to improve the quality and accessibility of Armenia's health care system, a host of factors has prevented the country from fully introducing measures to ensure respect for human rights in patient care. In particular, inadequate health care financing continues to oblige patients to make both formal and informal payments to obtain basic medical care and services. More generally, a lack of oversight and monitoring mechanisms has obstructed the implementation of Armenia's commitments to human rights in several international agreements. Within the framework of a broader project on promoting human rights in patient care, research was carried out to examine Armenia’s health care legislation with the aim of identifying gaps in comparison with international and regional standards. This research was designed using the 14 rights enshrined in the European Charter on Patient Rights as guiding principles, along with domestic legal acts relevant to the rights of health care providers. The gaps analysis revealed numerous problems with Armenian legislation governing the relationships between stakeholders in health care service delivery. It also identified several practical inconsistencies with the international legal instruments ratified by the Armenian government. These legislative shortcomings are illustrated by highlighting key health-related rights violations experienced by patients and their health care providers, and by indicating opportunities for improved rights protections. A full list of human rights relevant to patient care and recommendations for promoting them in the Armenian context is provided in Tables 1 and 2. A number of initiatives must be undertaken in order to promote the full spectrum of human rights in patient care in Armenia. This section highlights certain recommendations flowing from the findings of

  12. 40 CFR 160.12 - Statement of compliance or non-compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Statement of compliance or non-compliance. 160.12 Section 160.12 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS General Provisions § 160.12 Statement of compliance or...

  13. Closing the antidepressant efficacy gap between clinical trials and real patient populations.

    PubMed

    Wade, Alan G

    2006-01-01

    Overall, patient outcomes in the primary care of depression are seldom as good as those achieved in clinical trials - the "efficacy gap". Many factors contribute to this, including poor patient compliance, poor family and social support and negative media reporting of antidepressants. Indeed, negative media reporting has had far more impact on physicians' prescribing of antidepressants than have regulatory agencies, partly as a result of changing public attitudes. Negative media reports linking SSRIs to increased child suicide rates have also resulted in a decline in the prescribing of SSRIs to this age group, but with no concomitant increase in the prescribing of fluoxetine, the only antidepressant recommended for the treatment of children. There are also inadequacies in the guidelines available to primary care givers that might contribute to the efficacy gap. Guidelines can be too specific for clinical practice - especially where depression coexists with anxiety disorders - and too passive, resulting in delayed or inadequate intervention. Evidence suggests that many physicians prefer to be more proactive. In the recent AHEAD survey, physicians identified faster resolution of symptoms as the property most desirable for improving antidepressant therapy. There is recent evidence that structured long-term therapy and easily-implemented measurement-based care procedures can improve remission rates and help bridge the efficacy gap. If these can be allied with greater public/media understanding of depression and its treatment, along with improved guidelines, then significant progress can be anticipated in the management of mood disorders.

  14. Electron Elevator: Excitations across the Band Gap via a Dynamical Gap State.

    PubMed

    Lim, A; Foulkes, W M C; Horsfield, A P; Mason, D R; Schleife, A; Draeger, E W; Correa, A A

    2016-01-29

    We use time-dependent density functional theory to study self-irradiated Si. We calculate the electronic stopping power of Si in Si by evaluating the energy transferred to the electrons per unit path length by an ion of kinetic energy from 1 eV to 100 keV moving through the host. Electronic stopping is found to be significant below the threshold velocity normally identified with transitions across the band gap. A structured crossover at low velocity exists in place of a hard threshold. An analysis of the time dependence of the transition rates using coupled linear rate equations enables one of the excitation mechanisms to be clearly identified: a defect state induced in the gap by the moving ion acts like an elevator and carries electrons across the band gap.

  15. Patient compliance with telephone triage recommendations: a meta-analytic review.

    PubMed

    Purc-Stephenson, Rebecca J; Thrasher, Christine

    2012-05-01

    To systematically investigate the extent to which patients comply with triage advice from telenurses and to identify factors that potentially influence compliance. Findings from 13 studies identified through interdisciplinary research databases (1990-2010) were meta-analyzed. Separate pooled analyses compared patients' compliance rates for emergency services and office care (13 outcomes), emergency services and self care (13 outcomes), and self care and office care (12 outcomes). Overall patient compliance was 62%, but varied by intensity of care recommended with low compliance rates for advice to see a general practitioner. Reasons for noncompliance include patients reporting to have heard a different disposition, patients' intentions and health beliefs. Patient compliance to triage recommendations was influenced by the interactive role of patient perceptions and the quality of provider communication, both of which were mediated by access to health services. Further research is needed to clarify whether noncompliance is attributable to poor communication by the nurse or patient misinterpretation. We highlight the need for communication-skills training in a telephone-consultation context that is patient centered, and specifically addresses building active listening and active advising skills and advantages to structuring the call. Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All rights reserved.

  16. Antimicrobial stewardship in Victorian hospitals: a statewide survey to identify current gaps.

    PubMed

    James, Rodney S; McIntosh, Kylie A; Luu, Susan B; Cotta, Menino O; Marshall, Caroline; Thursky, Karin A; Buising, Kirsty L

    2013-11-18

    To determine antimicrobial stewardship (AMS) activities currently being undertaken at Victorian hospitals, identifying gaps when assessed against the Australian Commission on Safety and Quality in Health Care criteria for effective AMS. A survey open to all Victorian health services, conducted between January and March 2012. Availability of the endorsed prescribing guidelines, antimicrobial prescribing policies, formularies, approval systems for restricted antimicrobials, procedures for postprescription review, auditing and selective reporting of sensitivities. Response rates were 96.4% for public health services and 67.7% for private hospitals. Guidelines were available at all public and 88.1% of private hospitals, and 90.6% of public metropolitan, 45.7% of public regional and 21.4% of private hospitals had antimicrobial prescribing policies. Antimicrobial approval systems were used in 93.8% of public metropolitan, 17.3% of public regional and 4.8% of private hospitals. Prescribing audits were conducted by 62.5% of public metropolitan, 35.8% public regional and 52.4% of private hospitals. Nearly all hospitals had selective laboratory reporting of antimicrobial sensitivities. Few hospitals had dedicated funding for AMS personnel. We identified wide differences between hospital AMS activities. Additional support for AMS is particularly required in the public regional and private hospital sectors, principally in the key areas of policy development, antimicrobial approval systems, prescription review and auditing. Further research is required to develop recommendations for implementation of AMS within the regional and private hospital settings.

  17. 10 CFR 820.41 - Compliance order.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    .... The Secretary may issue to any person involved in a DOE nuclear activity a Compliance Order that: (a) Identifies a situation that violates, potentially violates, or otherwise is inconsistent with the Act, a...) States the reasons for the remedy or other action. ...

  18. Compliance with barrier precautions during paediatric trauma resuscitations.

    PubMed

    Kelleher, Deirdre C; Carter, Elizabeth A; Waterhouse, Lauren J; Burd, Randall S

    2013-03-01

    Barrier precautions protect patients and providers from blood-borne pathogens. Although barrier precaution compliance has been shown to be low among adult trauma teams, it has not been evaluated during paediatric resuscitations in which perceived risk of disease transmission may be low. The purpose of this study was to identify factors associated with compliance with barrier precautions during paediatric trauma resuscitations. Video recordings of resuscitations performed on injured children (<18 years old) were reviewed to determine compliance with an established policy requiring gowns and gloves. Depending on activation level, trauma team members included up to six physicians, four nurses, and a respiratory therapist. Multivariate logistic regression was used to determine the effect of team role, resuscitation factors, and injury mechanism on barrier precaution compliance. Over twelve weeks, 1138 trauma team members participated in 128 resuscitations (4.7% penetrating injuries, 9.4% highest level activations). Compliance with barrier precautions was 81.3%, with higher compliance seen among roles primarily at the bedside compared to positions not primarily at the bedside (90.7% vs. 65.1%, p<0.001). Bedside residents (98.4%) and surgical fellows (97.6%) had the highest compliance, while surgical attendings (20.8%) had the lowest (p<0.001). Controlling for role, increased compliance was observed during resuscitations of patients with penetrating injuries (OR=3.97 [95% CI: 1.35-11.70], p=0.01), during resuscitations triaged to the highest activation level (OR=2.61 [95% CI: 1.34-5.10], p=0.005), and among team members present before patient arrival (OR=4.14 [95% CI: 2.29-7.39], p<0.001). Compliance with barrier precautions varies by trauma team role. Team members have higher compliance when treating children with penetrating and high acuity injuries and when arriving before the patient. Interventions integrating barrier precautions into the workflow of team members are

  19. Electron elevator: Excitations across the band gap via a dynamical gap state

    DOE PAGES

    Lim, Anthony; Foulkes, W. M. C.; Horsfield, A. P.; ...

    2016-01-27

    We use time-dependent density functional theory to study self-irradiated Si. We calculate the electronic stopping power of Si in Si by evaluating the energy transferred to the electrons per unit path length by an ion of kinetic energy from 1 eV to 100 keV moving through the host. Electronic stopping is found to be significant below the threshold velocity normally identified with transitions across the band gap. A structured crossover at low velocity exists in place of a hard threshold. Lastly, an analysis of the time dependence of the transition rates using coupled linear rate equations enables one of themore » excitation mechanisms to be clearly identified: a defect state induced in the gap by the moving ion acts like an elevator and carries electrons across the band gap.« less

  20. [Treatment side effects and compliance in patients with depression].

    PubMed

    Petrova, N N; Kucher, E O

    2012-01-01

    The impact of treatment side-effects on the compliance was studied in 85 depressive patients with different mental disorders - recurrent depressive disorder, postschizophrenic depression and organic affective disorder. The comparison of objective and subjective evaluations of compliance and a comparative analysis of the level of compliance, with its dependence on the treatment specifics, in different diseases were done. A significant role of efficacy and treatment side-effects was identified. The levels of "mental" and "autonomous" side-effects were highest in the treatment of depression: patients with postschizophrenic depression had the highest risk in respect of maintenance treatment; patients with recurrent depressive disorder and organic (affective) disorder were more tolerant to the treatment side-effects and their treatment, including the maintenance therapy, was rather effective. The compliance of all patients with depression was negatively correlated with the severity of side-effects of pharmacotherapy. The greatest side-effects and the lowest level of compliance were observed in the complex treatment with antidepressants and atypical neuroleptics. The effect of side-effects on the compliance was dependent on their severity and subjective tolerability and, to a lesser extent, on the amount of drugs.

  1. Bridging the Civil Military Gap Capitalizing on Crisis

    DTIC Science & Technology

    2002-01-01

    solutions. Researchers identifying the sources of the gap discussed above, have also suggested some methods for reducing the gap . While some are policy...Strategy Research Project DATE: 09 April 2002 PAGES: 42 CLASSIFICATION: Unclassified Researchers have identified a "civil-military gap ," an observable...would indicate a desire by the civilian populous to draw closer to the military, creating an opportunity to close or at least narrow this gap . The media

  2. Identifying knowledge gaps between practice and research for implementation components of sustainable interventions to improve the working environment - A rapid review.

    PubMed

    Rasmussen, Charlotte Diana Nørregaard; Højberg, Helene; Bengtsen, Elizabeth; Jørgensen, Marie Birk

    2018-02-01

    In a recent study, we involved all relevant stakeholders to identify practice-based implementation components for successful implementation and sustainability in work environment interventions. To understand possible knowledge gaps between evidence and practice, the aim of this paper is to investigate if effectiveness studies of the 11 practice-based implementation components can be identified in existing scientific literature. PubMed/MEDLINE, PsycINFO, and Web of Science were searched for relevant studies. After screening, 38 articles met the inclusion criteria. Since some of the studies describe more than one practice-based implementation concept a total of 125 quality criteria assessments were made. The overall result is that 10 of the 11 practice-based implementation components can be found in the scientific literature, but the evaluation of them is poor. From this review it is clear that there are knowledge gaps between evidence and practice with respect to the effectiveness of implementation concepts. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. What improves environmental compliance? Evidence from Mexican industry

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dasgupta, S.; Hettige, H.; Wheeler, D.

    2000-01-01

    This paper uses new survey evidence to analyze the effects of regulation, plant-level management policies, and other factors on the environmental compliance of Mexican manufacturers. In Mexico and other developing countries, many plants avoid complying with regulations because monitoring and enforcement are sporadic. On the other hand, some plants overcomply because their abatement decisions are strongly affected by extra legal factors. The authors attempt to capture both possibilities in a model of decision making under uncertainty: A plant minimizes expected pollution-related costs by setting emissions intensity (emissions/output) at the point where marginal abatement cost is equal to the expected marginalmore » penalty for polluting. Compliance status is determined by the positive or negative gap between the regulatory standard and the plant's cost-minimizing emissions intensity. Among determinants of the latter, the authors focus particularly on environmental management policies: the degree of effort to reduce emissions, and the type of management strategy which is adopted. Recognizing that these policies and emissions are simultaneously determined, they use two-stage least squares for econometric estimation. Their results suggest that environmental management has a strong, independent effect on compliance, even after their control for simultaneity and take many other determinants of emissions intensity into account. The authors conclude that in developing countries with weak regulations, the carrot of subsidized environmental management training may provide a useful complement to the uncertain stick of conventional enforcement.« less

  4. Structural analyses of Legionella LepB reveal a new GAP fold that catalytically mimics eukaryotic RasGAP.

    PubMed

    Yu, Qin; Hu, Liyan; Yao, Qing; Zhu, Yongqun; Dong, Na; Wang, Da-Cheng; Shao, Feng

    2013-06-01

    Rab GTPases are emerging targets of diverse bacterial pathogens. Here, we perform biochemical and structural analyses of LepB, a Rab GTPase-activating protein (GAP) effector from Legionella pneumophila. We map LepB GAP domain to residues 313-618 and show that the GAP domain is Rab1 specific with a catalytic activity higher than the canonical eukaryotic TBC GAP and the newly identified VirA/EspG family of bacterial RabGAP effectors. Exhaustive mutation analyses identify Arg444 as the arginine finger, but no catalytically essential glutamine residues. Crystal structures of LepB313-618 alone and the GAP domain of Legionella drancourtii LepB in complex with Rab1-GDP-AlF3 support the catalytic role of Arg444, and also further reveal a 3D architecture and a GTPase-binding mode distinct from all known GAPs. Glu449, structurally equivalent to TBC RabGAP glutamine finger in apo-LepB, undergoes a drastic movement upon Rab1 binding, which induces Rab1 Gln70 side-chain flipping towards GDP-AlF3 through a strong ionic interaction. This conformationally rearranged Gln70 acts as the catalytic cis-glutamine, therefore uncovering an unexpected RasGAP-like catalytic mechanism for LepB. Our studies highlight an extraordinary structural and catalytic diversity of RabGAPs, particularly those from bacterial pathogens.

  5. Multi-compartment medication devices and patient compliance.

    PubMed

    McGraw, Caroline

    2004-07-01

    Multi-compartment medication compliance devices are widely used in primary care. The aim of this review is to reveal whether they are effective in promoting adherence among non-adherent adults living at home. Searches were undertaken using two electronic databases (Medline (1966-2003) and International Pharmaceutical Abstracts (1970-2002)). Only randomized controlled trials (including crossover studies) were included in the review. Participants had to be non-institutionalized adults receiving one or more prescription medicines each day and displaying problems with adherence. Studies had to compare multi-compartment medication compliance devices to standard packaging and outcome measures and to include either pill counts, biological assays and/or clinical response. Articles were selected if they described a follow up period of at least three months and demonstrated that over 80% of participants had completed the trial. Two studies were identified that met the criteria, reporting data on a total of 148 patients. The findings from the first study found diabetic patients receiving medication in a compliance device demonstrated better glucose control than patients receiving medication in standard packaging. The second study found compliance devices had no impact on blood pressure control in hypertensive patients. Further research needs to be conducted to assess the effectiveness of multi-compartment medication compliance devices in promoting adherence among non-adherent adults living at home.

  6. Factors Predicting Compliance to Ecological Momentary Assessment Among Adolescent Smokers

    PubMed Central

    2014-01-01

    Introduction: Ecological momentary assessments (EMAs) are increasingly used in smoking research to understand contextual and individual differences related to smoking and changes in smoking. To date, there has been little detailed research into the predictors of EMA compliance. However, patterns or predictors of compliance may affect key relationships under investigation and introduce sources of bias in results. The purpose of this study was to investigate predictors of compliance to random prompts among a sample of adolescents who had ever smoked. Methods: Data for this study were drawn from a sample of 461 adolescents (9th and 10th graders at baseline) participating in a longitudinal study of smoking escalation. We examined 2 outcomes: subject-level EMA compliance (overall rate of compliance over a week-long EMA wave), and in-the-moment prompt-level compliance to the most proximal random prompt. We investigated several covariates including gender, race, smoking rate, alcohol use, psychological symptomatology, home composition, mood, social context, time in study, inter-prompt interval, and location. Results: At the overall subject level, higher mean negative affect, smoking rate, alcohol use, and male gender predicted lower compliance with random EMA prompts. At the prompt level, after controlling for significant subject-level predictors of compliance, increased positive affect, being outside of the home, and longer inter-prompt interval predicted lower momentary compliance. Conclusions: This study identifies several factors associated with overall and momentary EMA compliance among a sample of adolescents participating in a longitudinal study of smoking. We also propose a conceptual framework for investigating the contextual and momentary predictors of compliance within EMA studies. PMID:24097816

  7. Determinants of compliance behaviours among patients undergoing hemodialysis in Malaysia.

    PubMed

    Chan, Yoke Mun; Zalilah, Mohd Shariff; Hii, Sing Ziunn

    2012-01-01

    Patients with end stage renal disease often fail to follow prescribed dietary and fluid regimen, leading to undesirable outcomes. This study aimed to examine and identify factors influencing dietary, fluid, medication and dialysis compliance behaviours in patients undergoing hemodialysis. This was a cross-sectional study which employed purposive sampling design. A total of 188 respondents were recruited from 14 dialysis centres in Malaysia between 2008-2011. Self-reported compliance behaviours and biochemical measurements were used as evaluation tools. Compliance rates of dietary, fluid, medication and dialysis were 27.7%, 24.5%, 66.5% and 91.0%, respectively. Younger, male, working patients and those with longer duration on hemodialysis were found more likely to be non-compliant. Lacks of adequate knowledge, inadequate self-efficacy skills, forgetfulness and financial constraints were the major perceived barriers towards better compliance to fluid, dietary, medication and dialysis, respectively. Healthcare professionals should recognise the factors hindering compliance from the patients' perspective while assisting them with appropriate skills in making necessary changes possible.

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

    PubMed

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

    2010-08-01

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

  9. 28 CFR 73.4 - Partial compliance not deemed compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ATTORNEY GENERAL BY AGENTS OF FOREIGN GOVERNMENTS § 73.4 Partial compliance not deemed compliance. The fact... or these regulations on the part of the agent; nor shall it indicate that the Attorney General has in...

  10. Gap Analysis: Rethinking the Conceptual Foundations

    DTIC Science & Technology

    2008-04-23

    there could exist a basis for gap in capability and, therefore, a desire to close the capability gap . What one desires versus what one has is, in...Analysis is not intended to close the space between the most distant extremes or the rarest occurrences. Rather, Gap Analysis is centered on the larger...åÖÉ=======- 13 - = = Research Objectives The process of identifying needs and unsatisfied desires, or gaps in capability—in essence, the goal—is

  11. Service Contract Compliance Management in Business Process Management

    NASA Astrophysics Data System (ADS)

    El Kharbili, Marwane; Pulvermueller, Elke

    Compliance management is a critical concern for corporations, required to respect contracts. This concern is particularly relevant in the context of business process management (BPM) as this paradigm is getting adopted more widely for-designing and building IT systems. Enforcing contractual compliance needs to be modeled at different levels of a BPM framework, which also includes the service layer. In this paper, we discuss requirements and methods for modeling contractual compliance for an SOA-supported BPM. We also show how business rule management integrated into an industry BPM tool allows modeling and processing functional and non-functional-property constraints which may be extracted from business process contracts. This work proposes a framework that responds to the requirements identified and proposes an architecture implementing it. Our approach is also illustrated by an example.

  12. Identifying the Real Technology Skills Gap: A Qualitative Look across Disciplines

    ERIC Educational Resources Information Center

    Schirf, Evan; Serapiglia, Anthony

    2017-01-01

    Every year several survey inventories are performed throughout the IT industry by trade magazines and research groups that attempt to gauge the current state of the industry as it relates to trends. Many of these highlight a technology skills gap between job expectations and potential employees. While many job openings exist and educational…

  13. 49 CFR 1119.1 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Compliance. 1119.1 Section 1119.1 Transportation... TRANSPORTATION RULES OF PRACTICE COMPLIANCE WITH BOARD DECISIONS § 1119.1 Compliance. A defendant or respondent... compliance date specified in the decision of the manner of compliance. Notification should be by verified...

  14. 49 CFR 1119.1 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 8 2011-10-01 2011-10-01 false Compliance. 1119.1 Section 1119.1 Transportation... TRANSPORTATION RULES OF PRACTICE COMPLIANCE WITH BOARD DECISIONS § 1119.1 Compliance. A defendant or respondent... compliance date specified in the decision of the manner of compliance. Notification should be by verified...

  15. Identification and characterization of ten new water gaps in seeds and fruits with physical dormancy and classification of water-gap complexes

    PubMed Central

    Gama-Arachchige, N. S.; Baskin, J. M.; Geneve, R. L.; Baskin, C. C.

    2013-01-01

    Background and Aims Physical dormancy (PY) occurs in seeds or fruits of 18 angiosperm families and is caused by a water-impermeable palisade cell layer(s) in seed or fruit coats. Prior to germination, the seed or fruit coat of species with PY must become permeable in order to imbibe water. Breaking of PY involves formation of a small opening(s) (water gap) in a morpho-anatomically specialized area in seeds or fruits known as the water-gap complex. Twelve different water-gap regions in seven families have previously been characterized. However, the water-gap regions had not been characterized in Cucurbitaceae; clade Cladrastis of Fabaceae; subfamilies Bombacoideae, Brownlowioideae and Bythnerioideae of Malvaceae; Nelumbonaceae; subfamily Sapindoideae of Sapindaceae; Rhamnaceae; or Surianaceae. The primary aims of this study were to identify and describe the water gaps of these taxa and to classify all the known water-gap regions based on their morpho-anatomical features. Methods Physical dormancy in 15 species was broken by exposing seeds or fruits to wet or dry heat under laboratory conditions. Water-gap regions of fruits and seeds were identified and characterized by use of microtome sectioning, light microscopy, scanning electron microscopy, dye tracking and blocking experiments. Key Results Ten new water-gap regions were identified in seven different families, and two previously hypothesized regions were confirmed. Water-gap complexes consist of (1) an opening that forms after PY is broken; (2) a specialized structure that occludes the gap; and (3) associated specialized tissues. In some species, more than one opening is involved in the initial imbibition of water. Conclusions Based on morpho-anatomical features, three basic water-gap complexes (Types-I, -II and -III) were identified in species with PY in 16 families. Depending on the number of openings involved in initial imbibition, the water-gap complexes were sub-divided into simple and compound. The

  16. Identification and characterization of ten new water gaps in seeds and fruits with physical dormancy and classification of water-gap complexes.

    PubMed

    Gama-Arachchige, N S; Baskin, J M; Geneve, R L; Baskin, C C

    2013-07-01

    Physical dormancy (PY) occurs in seeds or fruits of 18 angiosperm families and is caused by a water-impermeable palisade cell layer(s) in seed or fruit coats. Prior to germination, the seed or fruit coat of species with PY must become permeable in order to imbibe water. Breaking of PY involves formation of a small opening(s) (water gap) in a morpho-anatomically specialized area in seeds or fruits known as the water-gap complex. Twelve different water-gap regions in seven families have previously been characterized. However, the water-gap regions had not been characterized in Cucurbitaceae; clade Cladrastis of Fabaceae; subfamilies Bombacoideae, Brownlowioideae and Bythnerioideae of Malvaceae; Nelumbonaceae; subfamily Sapindoideae of Sapindaceae; Rhamnaceae; or Surianaceae. The primary aims of this study were to identify and describe the water gaps of these taxa and to classify all the known water-gap regions based on their morpho-anatomical features. Physical dormancy in 15 species was broken by exposing seeds or fruits to wet or dry heat under laboratory conditions. Water-gap regions of fruits and seeds were identified and characterized by use of microtome sectioning, light microscopy, scanning electron microscopy, dye tracking and blocking experiments. Ten new water-gap regions were identified in seven different families, and two previously hypothesized regions were confirmed. Water-gap complexes consist of (1) an opening that forms after PY is broken; (2) a specialized structure that occludes the gap; and (3) associated specialized tissues. In some species, more than one opening is involved in the initial imbibition of water. Based on morpho-anatomical features, three basic water-gap complexes (Types-I, -II and -III) were identified in species with PY in 16 families. Depending on the number of openings involved in initial imbibition, the water-gap complexes were sub-divided into simple and compound. The proposed classification system enables understanding of the

  17. The reasons for the epilepsy treatment gap in Kilifi, Kenya: using formative research to identify interventions to improve adherence to antiepileptic drugs.

    PubMed

    Carter, Julie A; Molyneux, Catherine S; Mbuba, Caroline K; Jenkins, Jo; Newton, Charles R J C; Hartley, Sally D

    2012-12-01

    Many people with epilepsy (PWE) in resource-poor countries do not receive appropriate treatment, a phenomenon referred to as the epilepsy treatment gap (ETG). We conducted a qualitative study to explore the reasons for this gap and to identify possible interventions in Kilifi, Kenya. Focus group discussions (FGDs) were carried out of PWE and their caregivers. Individual interviews were conducted of PWE, their caregivers, traditional healers, community health workers and leaders, nurses and doctors. In addition, a series of workshops was conducted, and four factors contributing to the ETG were identified: 1) lack of knowledge about the causes, treatment and prognosis of epilepsy; 2) inaccessibility to antiepileptic drugs; 3) misconceptions about epilepsy derived from superstitions about its origin; 4) and dissatisfaction with the communication skills of health providers. These data indicated possible interventions: 1) education and support for PWE and their caregivers; 2) communication skills training for health providers; 3) and improved drug provision. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Comparing U.S. Army Systems with Foreign Counterparts: Identifying Possible Capability Gaps and Insights from Other Armies

    DTIC Science & Technology

    2015-01-01

    C O R P O R A T I O N Research Report Comparing U.S. Army Systems with Foreign Counterparts Identifying Possible Capability Gaps and Insights from...Couffer; photo by E. Heidtmann, CC BY 3.0; photo by Black Mammmba, CC BY 3.0; and photo by Vitaly V. Kuzmin, CC BY 3.0. M1A2 Abrams Leopard 2A6 Merkava...photo by Mass Communication Specialist 1st Class Daniel N . Woods; photo by Daniel Steger, CC BY-SA 2.5; “MIL_Finlândia-Army_Demo Day 2005 Rovajärvellä

  19. Maternal compliance with nutritional recommendations in an allergy preventive programme

    PubMed Central

    Schoetzau, A; Gehring, U; Franke, K; Grubl, A; Koletzko, S; von Berg, A; Berdel, D; Reinhardt, D; Bauer, C; Wichmann, H

    2002-01-01

    Aims: To assess maternal compliance with nutritional recommendations in an allergy preventive programme, and identify factors influencing compliance behaviour. Methods: Randomised double-blind intervention study on the effect of infant formulas with reduced allergenicity in healthy, term newborns at risk of atopy. Maternal compliance with dietary recommendations concerning milk and solid food feeding was categorised. Results: A total of 2252 newborns were randomised to one of four study formulas. The drop out rate during the first year of life was 13.5% (n = 304). The rates of high, medium, and low compliance to milk feeding during weeks 1–16 were 83.4%, 4.0%, and 7.5%; the corresponding rates to solid food feeding during weeks 1–24 were 60.0%, 12.1%, and 22.9%. In 5.1% of subjects no nutritional information was available. Low compliance was more frequent among non-German parents, parents with a low level of education, young mothers, smoking mothers, and those who weaned their infant before the age of 2 months. Conclusions: Evaluation of allergy preventive programmes should take into account non-compliance for assessing the preventive effectiveness on study outcome. PMID:11861235

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

    PubMed

    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.

  1. Review and bibliometric analysis of published literature citing data produced by the Gap Analysis Program (GAP)

    USGS Publications Warehouse

    Ratz, Joan M.; Conk, Shannon J.

    2014-01-01

    The Gap Analysis Program (GAP) of the U.S. Geological Survey (USGS) produces geospatial datasets providing information on land cover, predicted species distributions, stewardship (ownership and conservation status), and an analysis dataset which synthesizes the other three datasets. The intent in providing these datasets is to support the conservation of biodiversity. The datasets are made available at no cost. The initial datasets were created at the state level. More recent datasets have been assembled at regional and national levels. GAP entered an agreement with the Policy Analysis and Science Assistance branch of the USGS to conduct an evaluation to describe the effect that using GAP data has on those who utilize the datasets (GAP users). The evaluation project included multiple components: a discussion regarding use of GAP data conducted with participants at a GAP conference, a literature review of publications that cited use of GAP data, and a survey of GAP users. The findings of the published literature search were used to identify topics to include on the survey. This report summarizes the literature search, the characteristics of the resulting set of publications, the emergent themes from statements made regarding GAP data, and a bibliometric analysis of the publications. We cannot claim that this list includes all publications that have used GAP data. Given the time lapse that is common in the publishing process, more recent datasets may be cited less frequently in this list of publications. Reports or products that used GAP data may be produced but never published in print or released online. In that case, our search strategies would not have located those reports. Authors may have used GAP data but failed to cite it in such a way that the search strategies we used would have located those publications. These are common issues when using a literature search as part of an evaluation project. Although the final list of publications we identified is not

  2. [Main causes of non-compliance with pulmonary tuberculosis treatment].

    PubMed

    Manjarréz Morales, E M; Serrano Montes, V; Cano Pérez, G; Verduzco Guerrero, E; Escandón Romero, C; Escobedo de la Peña, J

    1993-01-01

    One hundred rural patient with pulmonary tuberculosis and 74 urban patients were included in the study in order to study the main causes of non-compliance. Crude cumulative incidencia was 42% (73/164). Those factors with the strongest association with non-compliance, independently of its association with other factors, were to live in rural areas (OR 0 10.4; p < 0.001), had not gone to school (analfabet) (OR = 4.5; p < 0.001), and last more than an hour to reach the medical care unit (protector) (OR = 0.40; p = 0.07). No association was found with socioeconomic factors, neither with the patient's knowledge of the disease. Identifying those factors related to non-compliance is important, since non-compliance occurs in the very firsts days of treatment, when the shortage of treatment or giving fewer pills do not work at all. To get a better medial control may be a good way to reach the expected control of the disease.

  3. 28 CFR 12.70 - Partial compliance not deemed compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Partial compliance not deemed compliance. 12.70 Section 12.70 Judicial Administration DEPARTMENT OF JUSTICE REGISTRATION OF CERTAIN PERSONS HAVING KNOWLEDGE OF FOREIGN ESPIONAGE, COUNTERESPIONAGE, OR SABOTAGE MATTERS UNDER THE ACT OF AUGUST 1...

  4. 28 CFR 12.70 - Partial compliance not deemed compliance.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Partial compliance not deemed compliance. 12.70 Section 12.70 Judicial Administration DEPARTMENT OF JUSTICE REGISTRATION OF CERTAIN PERSONS HAVING KNOWLEDGE OF FOREIGN ESPIONAGE, COUNTERESPIONAGE, OR SABOTAGE MATTERS UNDER THE ACT OF AUGUST 1...

  5. 28 CFR 12.70 - Partial compliance not deemed compliance.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Partial compliance not deemed compliance. 12.70 Section 12.70 Judicial Administration DEPARTMENT OF JUSTICE REGISTRATION OF CERTAIN PERSONS HAVING KNOWLEDGE OF FOREIGN ESPIONAGE, COUNTERESPIONAGE, OR SABOTAGE MATTERS UNDER THE ACT OF AUGUST 1...

  6. 28 CFR 12.70 - Partial compliance not deemed compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Partial compliance not deemed compliance. 12.70 Section 12.70 Judicial Administration DEPARTMENT OF JUSTICE REGISTRATION OF CERTAIN PERSONS HAVING KNOWLEDGE OF FOREIGN ESPIONAGE, COUNTERESPIONAGE, OR SABOTAGE MATTERS UNDER THE ACT OF AUGUST 1...

  7. 28 CFR 12.70 - Partial compliance not deemed compliance.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Partial compliance not deemed compliance. 12.70 Section 12.70 Judicial Administration DEPARTMENT OF JUSTICE REGISTRATION OF CERTAIN PERSONS HAVING KNOWLEDGE OF FOREIGN ESPIONAGE, COUNTERESPIONAGE, OR SABOTAGE MATTERS UNDER THE ACT OF AUGUST 1...

  8. DISCONTOOLS: a database to identify research gaps on vaccines, pharmaceuticals and diagnostics for the control of infectious diseases of animals.

    PubMed

    O'Brien, Declan; Scudamore, Jim; Charlier, Johannes; Delavergne, Morgane

    2017-01-03

    The public and private sector in the EU spend around €800 million per year on animal health and welfare related research. An objective process to identify critical gaps in knowledge and available control tools should aid the prioritisation of research in order to speed up the development of new or improved diagnostics, vaccines and pharmaceuticals and reduce the burden of animal diseases. Here, we describe the construction of a database based on expert consultation for 52 infectious diseases of animals. For each disease, an expert group produced a disease and product analysis document that formed the basis for gap analysis and prioritisation. The prioritisation model was based on a closed scoring system, employing identical weights for six evaluation criteria (disease knowledge; impact on animal health and welfare; impact on public health; impact on wider society; impact on trade; control tools). The diseases were classified into three groups: epizootic diseases, food-producing animal complexes or zoonotic diseases. The highly ranked diseases in the prioritisation model comprised mostly zoonotic and epizootic diseases with important gaps identified in vaccine development and pharmaceuticals, respectively. The most important outcome is the identification of key research needs by disease. The rankings and research needs by disease are provided on a public website ( www.discontools.eu ) which is currently being updated based on new expert consultations. As such, it can become a reference point for funders of research including the European Commission, member states, foundations, trusts along with private industry to prioritise research. This will deliver benefits in terms of animal health and welfare but also public health, societal benefits and a safe and secure food supply.

  9. COMPLIANCE AND ENFORCEMENT REGIONAL TRACKING SYSTEM (CERTS)

    EPA Science Inventory

    The Compliance and Enforcement Regional Tracking System (CERTS) is a system that allows Region 10 employees integrated access to information in EPA national media data bases through the LAN system. CERTS will allow you to identify regulated facilities in a given location such as...

  10. Upper Body Venous Compliance Exceeds Lower Body Venous Compliance in Humans

    NASA Technical Reports Server (NTRS)

    Watenpaugh, Donald E.

    1996-01-01

    Human venous compliance hypothetically decreases from upper to lower body as a mechanism for maintenance of the hydrostatic indifference level 'headward' in the body, near the heart. This maintains cardiac filling pressure, and thus cardiac output and cerebral perfusion, during orthostasis. This project entailed four steps. First, acute whole-body tilting was employed to alter human calf and neck venous volumes. Subjects were tilted on a tilt table equipped with a footplate as follows: 90 deg, 53 deg, 30 deg, 12 deg, O deg, -6 deg, -12 deg, -6 deg, O deg, 12 deg, 30 deg, 53 deg, and 90 deg. Tilt angles were held for 30 sec each, with 10 sec transitions between angles. Neck volume increased and calf volume decreased during head-down tilting, and the opposite occurred during head-up tilt. Second, I sought to cross-validate Katkov and Chestukhin's (1980) measurements of human leg and neck venous pressures during whole-body tilting, so that those data could be used with volume data from the present study to calculate calf and neck venous compliance (compliance = (Delta)volume/(Delta)pressure). Direct measurements of venous pressures during postural chances and whole-body tilting confirmed that the local changes in venous pressures seen by Katkov and Chestukhin (1980) are valid. The present data also confirmed that gravitational changes in calf venous pressure substantially exceed those changes in upper body venous pressure. Third, the volume and pressure data above were used to find that human neck venous compliance exceeds calf venous compliance by a factor of 6, thereby upholding the primary hypothesis. Also, calf and neck venous compliance correlated significantly with each other (r(exp 2) = 0.56). Fourth, I wished to determine whether human calf muscle activation during head-up tilt reduces calf venous compliance. Findings from tilting and from supine assessments of relaxed calf venous compliance were similar, indicating that tilt-induced muscle activation is

  11. Study of self-compliance behaviors and internal filament characteristics in intrinsic SiO{sub x}-based resistive switching memory

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chang, Yao-Feng, E-mail: yfchang@utexas.edu; Zhou, Fei; Chen, Ying-Chen

    2016-01-18

    Self-compliance characteristics and reliability optimization are investigated in intrinsic unipolar silicon oxide (SiO{sub x})-based resistive switching (RS) memory using TiW/SiO{sub x}/TiW device structures. The program window (difference between SET voltage and RESET voltage) is dependent on external series resistance, demonstrating that the SET process is due to a voltage-triggered mechanism. The program window has been optimized for program/erase disturbance immunity and reliability for circuit-level applications. The SET and RESET transitions have also been characterized using a dynamic conductivity method, which distinguishes the self-compliance behavior due to an internal series resistance effect (filament) in SiO{sub x}-based RS memory. By using amore » conceptual “filament/resistive gap (GAP)” model of the conductive filament and a proton exchange model with appropriate assumptions, the internal filament resistance and GAP resistance can be estimated for high- and low-resistance states (HRS and LRS), and are found to be independent of external series resistance. Our experimental results not only provide insights into potential reliability issues but also help to clarify the switching mechanisms and device operating characteristics of SiO{sub x}-based RS memory.« less

  12. Determining Childhood Blood Lead Level Screening Compliance Among Physicians.

    PubMed

    Haboush-Deloye, Amanda; Marquez, Erika R; Gerstenberger, Shawn L

    2017-08-01

    Childhood Lead Poisoning Prevention Programs throughout the U.S. have addressed childhood lead poisoning by implementing primary and secondary prevention efforts. While many programs have helped increase screening rates, in some states children under the age of six still have not been tested for lead. This study aims to identify the barriers to childhood blood lead testing and develop a strategy to increase the number of children tested. Clark County physicians who work with children six and under were surveyed about blood lead level (BLL) testing practices, particularly, adherence to Centers for Disease Control and Prevention (CDC) guidelines, and parental compliance with orders to have their children tested to determine their blood lead levels. In addition, select in-person interviews were conducted with physicians who reported high parental compliance to identify best practices and barriers. Of the 77 physicians that provided data, 48% indicated they did not follow CDC guideline compared to 52% who follow guidelines. 18 of the 30 (or 60%) physicians reported more than 80% of parents complied with doctor recommended BLL testing. Twelve physicians identified cost, lack of insurance, and absence of symptomology as persistent barriers to lead screening. This study identified barriers to childhood lead screening including inadequate parental adherence to physician-ordered screenings and physician non-compliance with screening recommendations are two primary contributors. Addressing these issues could increase screening in children and reduce the risk of lead poisoning.

  13. Factors affecting patient compliance with compressive brace therapy for pectus carinatum.

    PubMed

    Kang, Du-Young; Jung, Junho; Chung, Sangho; Cho, Jinkyung; Lee, Sungsoo

    2014-12-01

    The aim of this study was to identify factors affecting patient compliance with brace therapy for pectus carinatum. Eighty-six pectus carinatum patients who started brace therapy from August 2008 to November 2011 were included in this study. Patients were divided into two groups: patients who wore the brace for ≥6 months (compliance group) or patients who wore the brace for <6 months (non-compliance group). Factors affecting patient compliance were assessed at the last day of follow-up with a multiple-choice questionnaire. The questionnaire comprised seven items: pain at compression site, skin problems on compression area, confidence in brace treatment, shame, discomfort, initial result of bracing treatment and total number of factors affecting patient compliance. Eighty-six patients completed the survey, including seven (8.1%) female patients and 79 (91.9%) male patients, with a mean age of 12.0 years at the time of treatment (range, 3-20 years). The initial result of the compression period (P <0.001) and total number of factors affecting patient compliance (P <0.05) were significant predictors of patient compliance. An initial successful result of the compression period may increase patient compliance during treatment for pectus carinatum. Additional efforts to decrease pain, skin problems, shame and discomfort, and to give confidence may be beneficial in increasing compliance with bracing treatment. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  14. Measuring outcomes in adult spinal deformity surgery: a systematic review to identify current strengths, weaknesses and gaps in patient-reported outcome measures.

    PubMed

    Faraj, Sayf S A; van Hooff, Miranda L; Holewijn, Roderick M; Polly, David W; Haanstra, Tsjitske M; de Kleuver, Marinus

    2017-08-01

    Adult spinal deformity (ASD) causes severe disability, reduces overall quality of life, and results in a substantial societal burden of disease. As healthcare is becoming more value based, and to facilitate global benchmarking, it is critical to identify and standardize patient-reported outcome measures (PROMs). This study aims to identify the current strengths, weaknesses, and gaps in PROMs used for ASD. Studies were included following a systematic search in multiple bibliographic databases between 2000 and 2015. PROMs were extracted and linked to the outcome domains of WHO's International Classification of Functioning and Health (ICF) framework. Subsequently, the clinimetric quality of identified PROMs was evaluated. The literature search identified 144 papers that met the inclusion criteria, and nine frequently used PROMs were identified. These covered 29 ICF outcome domains, which could be grouped into three of the four main ICF chapters: body function (n = 7), activity and participation (n = 19), environmental factors (n = 3), and body structure (n = 0). A low quantity (n = 3) of papers was identified that studied the clinimetric quality of PROMs. The Scoliosis Research Society (SRS)-22 has the highest level of clinimetric quality for ASD. Outcome domains related to mobility and pain were well represented. We identified a gap in current outcome measures regarding neurological and pulmonary function. In addition, no outcome domains were measured in the ICF chapter body structure. These results will serve as a foundation for the process of seeking international consensus on a standard set of outcome domains, accompanied PROMs and contributing factors to be used in future clinical trials and spine registries.

  15. Pediatric surgery fellowship compliance to the 80-hour work week.

    PubMed

    Ladd, Alan P

    2006-04-01

    The goal of this study was to determine the compliance of pediatric surgery fellowships with Accreditation Council for Graduate Medical Education (ACGME) duty hour restrictions while confronting a reduced resident workforce. An evaluation of training programs was performed by surveying pediatric surgery fellows on aspects of work hours, ACGME guideline compliance, operative case volume, employment of physician extenders, and didactic education. A 74% survey response rate was achieved. Of the respondents, 95% felt fully aware of ACGME guidelines. Although 95% of programs had mechanisms for compliance in place, only 45% of fellows felt compliant. Median work hours were 80 to 90 hours per week. Although subordinate residents were felt to obtain better compliance (>86%), only 69% of fellows perceived greater service commitment as a result. No impact on volume of operative cases was perceived. Of the programs, 89% employed physician extenders and 55% used additional fellows, but no overall effect on fellow work hours was evident. Fellows did not identify an improvement in the quality of clinical fellowships with guideline implementation. A minority of fellows comply with ACGME guidelines. Vigilance of duty hour tracking correlates to better compliance. A shift of patient care to fellows is perceived. Use of support personnel did not significantly aid compliance.

  16. Human Trafficking in Ethiopia: A Scoping Review to Identify Gaps in Service Delivery, Research, and Policy.

    PubMed

    Beck, Dana C; Choi, Kristen R; Munro-Kramer, Michelle L; Lori, Jody R

    2017-12-01

    The purpose of this review is to integrate evidence on human trafficking in Ethiopia and identify gaps and recommendations for service delivery, research and training, and policy. A scoping literature review approach was used to systematically search nursing, medical, psychological, law, and international databases and synthesize information on a complex, understudied topic. The search yielded 826 articles, and 39 met the predetermined criteria for inclusion in the review. Trafficking in Ethiopia has occurred internally and externally in the form of adult and child labor and sex trafficking. There were also some reports of organ trafficking and other closely related human rights violations, such as child marriage, child soldiering, and exploitative intercountry adoption. Risk factors for trafficking included push factors (poverty, political instability, economic problems, and gender discrimination) and pull factors (demand for cheap labor). Trafficking was associated with poor health and economic outcomes for victims. Key recommendations for service delivery, research and training, and policy are identified, including establishing comprehensive services for survivor rehabilitation and reintegration, conducting quantitative health outcomes research, and reforming policy around migration and trafficking. Implementing the recommendations identified by this review will allow policy makers, researchers, and practitioners to take meaningful steps toward confronting human trafficking in Ethiopia.

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

    ERIC Educational Resources Information Center

    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…

  18. Closing the gap between research and management

    Treesearch

    Deborah M. Finch; Marcia Patton-Mallory

    1993-01-01

    In this paper, we evaluate the reasons for gaps in communication between researchers and natural resource managers and identify methods to close these gaps. Gaps originate from differing patterns of language use, disparities in organizational culture and values, generation of knowledge that is too narrowly-focused to solve complex problems, failure by managers to relay...

  19. Achieving compliance with the International Health Regulations by overseas territories of the United Kingdom of Great Britain and Northern Ireland.

    PubMed

    Hamblion, Esther L; Salter, Mark; Jones, Jane

    2014-11-01

    The 2005 International Health Regulations (IHR) came into force for all Member States of the World Health Organization (WHO) in June 2007 and the deadline for achieving compliance was June 2012. The purpose of the IHR is to prevent, protect against, control - and provide a public health response to - international spread of disease. The territory of the United Kingdom of Great Britain and Northern Ireland and that of several other Member States, such as China, Denmark, France, the Netherlands and the United States of America, include overseas territories, which cover a total population of approximately 15 million people. Member States have a responsibility to ensure that all parts of their territory comply with the IHR. Since WHO has not provided specific guidance on compliance in the special circumstances of the overseas territories of Member States, compliance by these territories is an issue for self-assessment by Member States themselves. To date, no reports have been published on the assessment of IHR compliance in countries with overseas territories. We describe a gap analysis done in the United Kingdom to assess IHR compliance of its overseas territories. The findings and conclusions are broadly applicable to other countries with overseas territories which may have yet to assess their compliance with the IHR. Such assessments are needed to ensure compliance across all parts of a Member States' territory and to increase global health security.

  20. 28 CFR 811.11 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Compliance. 811.11 Section 811.11... OFFENDER REGISTRATION § 811.11 Compliance. (a) A sex offender may be excused from strict compliance with... circumstances that will interfere with compliance and makes alternative arrangements to satisfy the requirements...

  1. 28 CFR 811.11 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Compliance. 811.11 Section 811.11... OFFENDER REGISTRATION § 811.11 Compliance. (a) A sex offender may be excused from strict compliance with... circumstances that will interfere with compliance and makes alternative arrangements to satisfy the requirements...

  2. 10 CFR 434.604 - Compliance.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Compliance. 434.604 Section 434.604 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.604 Compliance. 604.1 Compliance with this section is...

  3. 10 CFR 434.604 - Compliance.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Compliance. 434.604 Section 434.604 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.604 Compliance. 604.1 Compliance with this section is...

  4. 10 CFR 434.604 - Compliance.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Compliance. 434.604 Section 434.604 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.604 Compliance. 604.1 Compliance with this section is...

  5. 10 CFR 434.604 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Compliance. 434.604 Section 434.604 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.604 Compliance. 604.1 Compliance with this section is...

  6. 10 CFR 434.604 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Compliance. 434.604 Section 434.604 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Compliance Alternative § 434.604 Compliance. 604.1 Compliance with this section is...

  7. Factors that interfere the medication compliance in hypertensive patients

    PubMed Central

    Daniel, Ana Carolina Queiroz Godoy; Veiga, Eugenia Velludo

    2013-01-01

    ABSTRACT Objective: To characterize the factors that interfere in drug treatment compliance in a group of individuals with arterial hypertension. Methods: A non-experimental descriptive study that analyzed a sample of 80 patients diagnosed with arterial hypertension, who underwent medical treatment and were admitted to a university hospital during the period from March to May 2009. To collect data, the Instrument for Evaluation of Attitudes Regarding Taking Medication was applied. Results: In the studied population, 45.1% had sufficient degree of compliance to drug therapy. Individuals with controlled blood pressure, females, white, single, married or widowed, retired, aged between 40 and 59 years, and those aged above 80 years were the interviewees who answered positively regarding compliance and follow-up of drug therapy. Conclusion: Despite the fact that the number of factors that facilitate the process of compliance to drug treatment is greater than the number of complicating factors, we found that more than half of the patients surveyed had an insufficient degree of compliance with drug treatment for high blood pressure, which demonstrates the need to develop studies aimed to identify these factors and their contribution to the promotion of patient autonomy, acceptance, awareness and adaptation regarding their illness. PMID:24136760

  8. Developing a Gap Taxonomy to Address Crew Health Risks in NASA's Human Research Program

    NASA Technical Reports Server (NTRS)

    Kundrot, Craig E.; Edwards, J. Michelle

    2009-01-01

    The mission of NASA's Human Research Program (HRP) is to understand and reduce the risk to crew health and performance in exploration missions. The HRP addresses 27 specific risks by identifying and then filling gaps in understanding the risks and in the ability to disposition the risks. The primary bases for identifying gaps have been past experience and requirements definition. This approach has been very effective in identifying some important, relevant gaps, but may be inadequate for identifying gaps outside the past experience base. We are exploring the use of a gap taxonomy as a comprehensive, underlying conceptual framework that allows a more systematic identification of gaps. The taxonomy is based on these stages in medical care: prediction, prevention, detection/diagnosis, treatment, monitoring, rehabilitation, and lifetime surveillance. This gap taxonomy approach identifies new gaps in HRP health risks. Many of the new gaps suggest risk reduction approaches that are more cost effective than present approaches. A major benefit of the gap taxonomy approach is to identify new, economical approaches that reduce the likelihood and/or consequence of a risk.

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

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Compliance and risk management programs... Practices and Procedures § 1710.19 Compliance and risk management programs; compliance with other laws. (a... management program. (1) An Enterprise shall establish and maintain a risk management program that is...

  10. 40 CFR 792.12 - Statement of compliance or non-compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 32 2011-07-01 2011-07-01 false Statement of compliance or non-compliance. 792.12 Section 792.12 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS General Provisions § 792.12 Statement...

  11. Health Research and Millennium Development Goals: Identifying the Gap From Public Health Perspective

    PubMed Central

    El Lawindi, Mona I.; Galal, Yasmine S.; Khairy, Walaa A.

    2016-01-01

    Assessing the research output within the universities could provide an effective means for tracking the Millennium Development Goals (MDGs) progress. This analytical database study was designed to assess the trend of research theses conducted by the Public Health Department (PHD), Faculty of Medicine, Cairo University during the period 1990 to 2014 as related to the: MDGS, Faculty and department research priority plans and to identify the discrepancies between researchers’ priorities versus national and international research priorities. A manual search of the theses was done at the Postgraduate Library using a specially designed checklist to chart adherence of each thesis to: MDGs, Faculty and department research plans (RPs). The theses’ profile showed that the highest research output was for addressing the MDGS followed by the PHD and Faculty RPs. Compliance to MDGs 5 and 6 was obvious, whereas; MDGs 2, 3, and 7 were not represented at all after year 2000. No significant difference was found between PH theses addressing the Faculty RPs and those which were not before and after 2010. A significantly lower percent of PH theses was fulfilling the PHD research priorities compared to those which were not after 2010. This study showed a definite decline in research output tackling the MDGS and PHD research priorities, with a non-significant increase in the production of theses addressing the Faculty RPs. The present study is a practical model for policy makers within the universities to develop and implement a reliable monitoring and evaluation system for assessment of research output. PMID:26652084

  12. Health Research and Millennium Development Goals: Identifying the Gap From Public Health Perspective.

    PubMed

    El Lawindi, Mona I; Galal, Yasmine S; Khairy, Walaa A

    2015-08-23

    Assessing the research output within the universities could provide an effective means for tracking the Millennium Development Goals (MDGs) progress. This analytical database study was designed to assess the trend of research theses conducted by the Public Health Department (PHD), Faculty of Medicine, Cairo University during the period 1990 to 2014 as related to the: MDGS, Faculty and department research priority plans and to identify the discrepancies between researchers' priorities versus national and international research priorities. A manual search of the theses was done at the Postgraduate Library using a specially designed checklist to chart adherence of each thesis to: MDGs, Faculty and department research plans (RPs). The theses' profile showed that the highest research output was for addressing the MDGS followed by the PHD and Faculty RPs. Compliance to MDGs 5 and 6 was obvious, whereas; MDGs 2, 3, and 7 were not represented at all after year 2000. No significant difference was found between PH theses addressing the Faculty RPs and those which were not before and after 2010. A significantly lower percent of PH theses was fulfilling the PHD research priorities compared to those which were not after 2010. This study showed a definite decline in research output tackling the MDGS and PHD research priorities, with a non-significant increase in the production of theses addressing the Faculty RPs. The present study is a practical model for policy makers within the universities to develop and implement a reliable monitoring and evaluation system for assessment of research output.

  13. 40 CFR 74.41 - Identifying allowances.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Identifying allowances. 74.41 Section 74.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) SULFUR DIOXIDE OPT-INS Allowance Tracking and Transfer and End of Year Compliance § 74.41 Identifying...

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

    NASA Astrophysics Data System (ADS)

    Roux, Izak Johannes, III

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

  15. 40 CFR 763.97 - Compliance and enforcement.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... CONTROL ACT ASBESTOS Asbestos-Containing Materials in Schools § 763.97 Compliance and enforcement. (a... Title II of the Act should direct the complaint to the Governor of the State or the EPA Asbestos... identified as a citizen complaint pursuant to section 207(d) of Title II of TSCA. The EPA Asbestos Ombudsman...

  16. 40 CFR 763.97 - Compliance and enforcement.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... CONTROL ACT ASBESTOS Asbestos-Containing Materials in Schools § 763.97 Compliance and enforcement. (a... Title II of the Act should direct the complaint to the Governor of the State or the EPA Asbestos... identified as a citizen complaint pursuant to section 207(d) of Title II of TSCA. The EPA Asbestos Ombudsman...

  17. 40 CFR 763.97 - Compliance and enforcement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... CONTROL ACT ASBESTOS Asbestos-Containing Materials in Schools § 763.97 Compliance and enforcement. (a... Title II of the Act should direct the complaint to the Governor of the State or the EPA Asbestos... identified as a citizen complaint pursuant to section 207(d) of Title II of TSCA. The EPA Asbestos Ombudsman...

  18. 40 CFR 763.97 - Compliance and enforcement.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... CONTROL ACT ASBESTOS Asbestos-Containing Materials in Schools § 763.97 Compliance and enforcement. (a... Title II of the Act should direct the complaint to the Governor of the State or the EPA Asbestos... identified as a citizen complaint pursuant to section 207(d) of Title II of TSCA. The EPA Asbestos Ombudsman...

  19. 40 CFR 763.97 - Compliance and enforcement.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... CONTROL ACT ASBESTOS Asbestos-Containing Materials in Schools § 763.97 Compliance and enforcement. (a... Title II of the Act should direct the complaint to the Governor of the State or the EPA Asbestos... identified as a citizen complaint pursuant to section 207(d) of Title II of TSCA. The EPA Asbestos Ombudsman...

  20. 23 CFR 230.415 - Consolidated compliance reviews.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... target area. In identifying the target area of a consolidated compliance review (e.g. SMSA, hometown or...) Present or potential problem areas; (iv) The number of highway projects in the target area; and (v... review period. After the target area has been selected, the dates for the actual onsite reviews shall be...

  1. Tire Crumb Research Study Literature Review / Gap ...

    EPA Pesticide Factsheets

    In order to more fully understand data gaps in human exposure and toxicity to tire crumb materials, ATSDR, CPSC and EPA undertook a collaborative effort in the form of a scientific literature review and subsequent gaps analysis. The first objective of the Literature Review and Gap Analysis (LRGA) collaboration was to identify the existing body of literature related specifically to human exposure to tire crumb materials through the use of synthetic turf athletic fields and playgrounds. The second objective was to characterize and summarize the relevant data from the scientific literature. The final objective was to review the summary information and identify data gaps to build on the current understanding of the state-of-the-science and inform the development of specific research efforts that would be most impactful in the near-term. Because of the need for additional information, the U.S. Environmental Protection Agency (EPA), the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry (ATSDR), and the U.S. Consumer Product Safety Commission (CPSC) launched a multi-agency action plan to study key environmental human health questions. The Federal Research Action Plan includes numerous activities, including research studies (U.S. EPA, 2016). A key objective of the Action Plan is to identify key knowledge gaps.

  2. Finding Platinum-Coating Gaps On Titanium Anodes

    NASA Technical Reports Server (NTRS)

    Bodemeijer, Ronnald; Flowers, Cecil E.

    1990-01-01

    Simple procedure makes gaps visible to eye. New gap-detection method consists of plating thin layer of non-silver-colored metal like copper or gold on anode. Contrast in color between plated metal and bare anode material makes gaps stand out. If anode passes inspection, copper or gold plate removable by reversal of test-plating current. Remains to be determined whether test plating and removal damages anode. New method simpler and more economical than previous attempts to identify gaps in platinum.

  3. Patient compliance to wear orthodontic retainers during postretention may vary by age, gender, and time since braces were removed.

    PubMed

    Vig, Katherine W L

    2012-09-01

    During January to July 2008 a questionnaire was mailed to 1085 subjects who had completed comprehensive orthodontic fixed-appliance treatment from 6 months to 6 years following active tooth movement. This yielded 280 responses (25.8% response rate) after 2 mailings, 3 months apart. The respondents ranged in age from 8 to 72 years. Respondents were from various socioeconomic groups and urban or rural environments. Identifiers allowed respondents to be classified into subgroups. Predictors of compliance among patients/subjects who were provided with removable vacuum-formed retainers (VFRs) or Hawley retainers in the postretention phase of orthodontic treatment. The main outcome measure was self-reported compliance with different types of removable orthodontic retainers worn during the postretention phase of treatment. A logistic regression model identified probabilities of retainer wear, including a likelihood ratio to test the model parameters using chi-square statistics to identify significant variables. The model found age, gender, amount of time since braces were removed, type of retainer, and interpretation of compliance in retainer wear to be statistically significant variables. Time on retainer compliance revealed better compliance with VFR than Hawley retainers during the first 2 years after braces were removed, but then compliance increased with Hawley retainers and overall compliance was greater with Hawley retainers. Compliance with wearing removable retainers was initially better with VFRs but over time was greater with Hawley retainers, and esthetics was not a determinant. Several variables determined compliance, including age, gender, and type of retainer. Copyright © 2012. Published by Mosby, Inc. All rights reserved.

  4. A review of compliance to treatment in Alzheimer's disease: potential benefits of a transdermal patch.

    PubMed

    Small, Gary; Dubois, Bruno

    2007-11-01

    Following prescribed medication regimens is essential for the effective treatment of any medical condition. Unfortunately, patients often fail to follow recommendations, and treatment non-compliance represents a widespread, often underestimated problem, placing tremendous burden on the healthcare system. Compliance in Alzheimer's disease (AD), a chronic neurodegenerative disease typically afflicting older adults, is especially challenging. To review factors contributing to poor treatment compliance in AD, considering the prominent role care givers often play in treatment management; and acknowledging strategic approaches, particularly modern transdermal patches, to improve compliance in this particularly susceptible population. Articles were identified by searching MEDLINE in November 2006 (search limits: 1987-2007) using the terms: compliance; Alzheimer's; treatment; and transdermal. Additional resources included bibliographies of identified articles. Strategic approaches to improving treatment compliance include: simplifying treatment regimens, using reminder packaging, and developing more patient- or caregiver-friendly modes of administration. To date, AD therapies have been administered orally. However, recent developments in alternative modes of drug delivery, such as transdermal patches, may offer effective, well-tolerated treatment options with the potential to enhance compliance. A patch containing rivastigmine (Exelon), an established cholinesterase inhibitor, has been developed and demonstrated to have good efficacy and tolerability in patients with AD. In addition, initial caregiver experience suggests preference for the patch over oral administration. Transdermal patches may be an effective way to optimize treatment compliance for AD, as well as an increasing number of other chronic conditions that typically afflict the older population, offering the possibility of more sustained clinical benefits.

  5. Securing revenue through improved managed care compliance.

    PubMed

    Lomicka, Edward W

    2002-09-01

    Providers risk losing significant revenue when managed care contractual obligations go unmet. Contracts should identify claim payment expectations and limit administrative responsibilities tied to nonroutine services. Multidepartmental cooperation is needed to ensure compliance before, during, and after service delivery. Providers should employ technology to manage data related to copayment requirements, claims appeals, and patient eligibility.

  6. Microprocessor controlled compliance monitor for eye drop medication.

    PubMed

    Hermann, M M; Diestelhorst, M

    2006-07-01

    The effectiveness of a self administered eye drop medication can only be assessed if the compliance is known. The authors studied the specificity and sensitivity of a new microprocessor controlled monitoring device. The monitoring system was conducted by an 8 bit microcontroller for data acquisition and storage with sensors measuring applied pressure to the bottle, temperature, and vertical position. 10 devices were mounted under commercial 10 ml eye drops. Test subjects had to note down each application manually. A total of 15 applications each within 3 days was intended. Manual reports confirmed 15 applications for each of the 10 bottles. The monitoring devices detected a total of 149 events; one was missed; comprising a sensitivity of 99%. Two devices registered three applications, which did not appear in the manual protocols, indicating a specificity of about 98%. Refrigerated bottles were correctly identified. The battery lifetime exceeded 60 days. The new monitoring device demonstrated a high reliability of the collected compliance data. The important, yet often unknown, influence of compliance in patient care and clinical trials shall be illuminated by the new device. This may lead to a better adapted patient care. Studies will profit from a higher credibility and results will be less influenced by non-compliance.

  7. Achieving compliance with the International Health Regulations by overseas territories of the United Kingdom of Great Britain and Northern Ireland

    PubMed Central

    Salter, Mark; Jones, Jane

    2014-01-01

    Abstract The 2005 International Health Regulations (IHR) came into force for all Member States of the World Health Organization (WHO) in June 2007 and the deadline for achieving compliance was June 2012. The purpose of the IHR is to prevent, protect against, control – and provide a public health response to – international spread of disease. The territory of the United Kingdom of Great Britain and Northern Ireland and that of several other Member States, such as China, Denmark, France, the Netherlands and the United States of America, include overseas territories, which cover a total population of approximately 15 million people. Member States have a responsibility to ensure that all parts of their territory comply with the IHR. Since WHO has not provided specific guidance on compliance in the special circumstances of the overseas territories of Member States, compliance by these territories is an issue for self-assessment by Member States themselves. To date, no reports have been published on the assessment of IHR compliance in countries with overseas territories. We describe a gap analysis done in the United Kingdom to assess IHR compliance of its overseas territories. The findings and conclusions are broadly applicable to other countries with overseas territories which may have yet to assess their compliance with the IHR. Such assessments are needed to ensure compliance across all parts of a Member States’ territory and to increase global health security. PMID:25378745

  8. Non-surgical and supportive periodontal therapy: predictors of compliance

    PubMed Central

    Delatola, Chrysoula; Adonogianaki, Evagelia; Ioannidou, Effie

    2015-01-01

    Aim To identify predictors of compliance during non-surgical and supportive periodontal therapy (SPT). Materials and Methods In this retrospective study, demographic, dental, medical data of 427 new patients in a private practice were collected. Data were analysed in statistical models with non-surgical therapy and SPT compliance used as dependent variables. Results Of the 427 patients, 17.3% never agreed to initial therapy, 10.7% never completed therapy and 20.8% completed treatment, but never entered SPT. Of the 218 SPT patients, 56% became non-attenders after a period of 20 months, 33% were erratic attenders and 10.5% were regular attenders until the end of the observation period (5.5–6.5 years). Patients became erratic attenders after a mean period of regular attendance of 18.1 ± 16.2 months, whereas 49.6% of the patients, who abandoned SPT, were regular attenders until the time they stopped. In a univariate correlation model, periodontal disease severity emerged as a significant predictor of the completion of non-surgical periodontal therapy (p = 0.01). In a multivariate linear regression model, smoking was negatively associated with SPT compliance (p = 0.047). Conclusions A low compliance of the population was observed. Smoking and periodontal disease severity represented significant, but modest modifiers of a patient compliance with SPT and initial therapy respectively. PMID:24813661

  9. Identifying and Prioritizing Implementation Barriers, Gaps, and Strategies Through the Nigeria Implementation Science Alliance: Getting to Zero in the Prevention of Mother-to-Child Transmission of HIV.

    PubMed

    Ezeanolue, Echezona E; Powell, Byron J; Patel, Dina; Olutola, Ayodotun; Obiefune, Michael; Dakum, Patrick; Okonkwo, Prosper; Gobir, Bola; Akinmurele, Timothy; Nwandu, Anthea; Torpey, Kwasi; Oyeledum, Bolanle; Aina, Muyiwa; Eyo, Andy; Oleribe, Obinna; Ibanga, Ikoedem; Oko, John; Anyaike, Chukwuma; Idoko, John; Aliyu, Muktar H; Sturke, Rachel; Watts, Heather; Siberry, George

    2016-08-01

    In 2013, Nigeria accounted for 15% of the 1.3 million pregnant women living with HIV in sub-Saharan Africa and 26% of new infections among children worldwide. Despite this, less than 20% of pregnant women in Nigeria received an HIV test during pregnancy, and only 23% of HIV-infected pregnant women received appropriate intervention following HIV diagnosis. This article reports findings from 2 structured group exercises conducted at the first Nigeria Implementation Science Alliance Conference to identify (1) barriers and research gaps related to prevention of mother-to-child transmission (PMTCT) and (2) potential strategies and interventions that could address PMTCT challenges. Two 1-hour structured group exercises were conducted with 10 groups of 14-15 individuals (n = 145), who were asked to brainstorm barriers and strategies and to rank their top 3 in each category. Data analysis eliminated duplicate responses and categorized each of the priorities along the HIV care continuum: HIV diagnosis, linkage to care, or retention in care. Participating stakeholders identified 20 unique barriers and research gaps related to PMTCT across the HIV continuum. Twenty-five unique interventions and implementation strategies were identified. Similar to the barriers and research gaps, these interventions and strategies were distributed across the HIV care continuum. The barriers and strategies identified in this study represent important pathways to progress addressing MTCT. The deliberate involvement of state and federal policy makers, program implementers, and researchers helps ensure that they are relevant and actionable.

  10. Waste Isolation Pilot Plant Biennial Environmental Compliance Report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Westinghouse TRU Solutions

    This Biennial Environmental Compliance Report (BECR) documents environmental regulatory compliance at the Waste Isolation Pilot Plant (WIPP), a facility designed for the safe disposal of transuranic (TRU) radioactive waste, for the reporting period of April 1, 1998, to March 31, 2000. As required by the WIPP Land Withdrawal Act (LWA)(Public Law [Pub. L.] 102-579, and amended by Pub. L. 104-201), the BECR documents U.S. Department of Energy (DOE) Carlsbad Area Office's (hereinafter the ''CAO'') compliance with applicable environmental protection laws and regulations implemented by agencies of the federal government and the state of New Mexico. An issue was identified inmore » the 1998 BECR relating to a potential cross-connection between the fire-water systems and the site domestic water system. While the CAO and its managing and operating contractor (hereinafter the ''MOC'') believe the site was always in compliance with cross-connection control requirements, hardware and procedural upgrades w ere implemented in March 1999 to strengthen its compliance posture. Further discussion of this issue is presented in section 30.2.2 herein. During this reporting period WIPP received two letters and a compliance order alleging violation of certain requirements outlined in section 9(a)(1) of the LWA. With the exception of one item, pending a final decision by the New Mexico Environment Department (NMED), all alleged violations have been resolved without the assessment of fines or penalties. Non-mixed TRU waste shipments began on March 26, 1999. Shipments continued through November 26, 1999, the effective date of the Waste Isolation Pilot Plant Hazardous Waste Facility Permit (NM4890139088-TSDF). No shipments regulated under the Hazardous Waste Facility Permit were received at WIPP during this BECR reporting period.« less

  11. 76 FR 3825 - Regulatory Compliance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-21

    ... Compliance Memorandum for the Heads of Executive Departments and Agencies My Administration is committed to... regulatory compliance and enforcement activities, such as information with respect to administrative... compliance information fosters fair and consistent enforcement of important regulatory obligations. Such...

  12. Environmental surveillance and compliance at Los Alamos during 1996

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    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,more » 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.« less

  13. Factors affecting compliance and resistance to auditory command hallucinations: perceptions of a clinical population.

    PubMed

    Barrowcliff, Alastair L; Haddock, Gillian

    2010-12-01

    Elements of voice content and characteristics of a hallucinatory voice are considered to be associated with compliance and resistance to auditory command hallucinations. However, a need for further exploration of such features remains. To explore the associations across different types of commands (benign, self-harm, harm-other) with a range of symptom measures and a trait measure of expressed compliance with compliance to the most recent command and command hallucinations over the previous 28 days. Participants meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for schizophrenia or schizoaffective disorder, with auditory hallucinations in the previous 28 days were screened. Where commands were reported a full-assessment of positive symptoms, social-rank, beliefs about voices and trait compliance was completed. Compliance with the last self-harm command was associated with elevated voice malevolence, heightened symptom presentation and perceived consequences for non-compliance. Compliance with the last harm-other command was associated with elevated symptom severity, higher perceived consequences for non-compliance and higher levels of voice social rank. However, these associations were not maintained for compliance during the previous 28 days. Findings indicate the importance of identifying the content of commands, overall symptom severity and core variables associated with compliance to specific command categories. The temporal stability of established mediating variables needs further examination.

  14. Identification of Lightning Gaps in Mangrove Forests Using Airborne LIDAR Measurements

    NASA Astrophysics Data System (ADS)

    Zhang, K.

    2006-12-01

    Mangrove forests are highly dynamic ecosystems and change frequently due to tropical storms, frost, and lightning. These factors can cause gaps in mangrove forests by damaging trees. Compared to gaps generated by storms and frost, gaps caused by lightning strikes are small, ranging from 50 to 300 m2. However, these small gaps may play a critical role in mangrove forest dynamics because of the frequent occurrence of lightning in tropical areas. It has been hypothesized that the turnover of mangrove forests is mainly due to the death and regeneration of trees in lightning gaps. However, there is a lack of data for gap occurrence in mangrove forests to verify this hypothesis. It is impractical to measure gaps through a field survey on a large scale because of the logistic difficulties of muddy mangrove forests. Airborne light detection and ranging (LIDAR) technology is an effective alternative because it provides direct measurements of ground and canopy elevations remotely. This study developed a method to identify lightning gaps in mangrove forests in terms of LIDAR measurements. First, LIDAR points are classified into vegetation and ground measurements using the progressive morphological filter. Second, a digital canopy model (DCM) is generated by subtracting a digital terrain model (DTM) from a digital surface model (DSM). The DSM is generated by interpolating raw LIDAR measurements, and DTM is produced by interpolating ground measurements. Third, a black top-hat mathematical morphological transformation is used to identify canopy gaps. Comparison of identified gap polygons with raw LIDAR measurements and field surveys shows that the proposed method identifies lightning gaps in mangrove forests successfully. The area of lightning gaps in mangrove forests in Everglades National Park is about 3% of total forest area, which verifies that lightning gaps play a critical role in mangrove forest turnover.

  15. Difficulties Using Standardized Tests to Identify the Receptive Expressive Gap in Bilingual Children's Vocabularies.

    PubMed

    Gibson, Todd A; Oller, D Kimbrough; Jarmulowicz, Linda

    2018-03-01

    Receptive standardized vocabulary scores have been found to be much higher than expressive standardized vocabulary scores in children with Spanish as L1, learning L2 (English) in school (Gibson et al., 2012). Here we present evidence suggesting the receptive-expressive gap may be harder to evaluate than previously thought because widely-used standardized tests may not offer comparable normed scores. Furthermore monolingual Spanish-speaking children tested in Mexico and monolingual English-speaking children in the US showed other, yet different statistically significant discrepancies between receptive and expressive scores. Results suggest comparisons across widely used standardized tests in attempts to assess a receptive-expressive gap are precarious.

  16. Interventions to improve hand hygiene compliance in patient care.

    PubMed

    Gould, Dinah J; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H; Taljaard, Monica

    2017-09-01

    certainty of evidence. With the identified variability in certainty of evidence, interventions, and methods, there remains an urgent need to undertake methodologically robust research to explore the effectiveness of multimodal versus simpler interventions to increase hand hygiene compliance, and to identify which components of multimodal interventions or combinations of strategies are most effective in a particular context.

  17. Combined hormonal contraceptives: prescribing patterns, compliance, and benefits versus risks.

    PubMed

    Brynhildsen, Jan

    2014-10-01

    Combined hormonal contraceptives [combined oral contraceptives (COCs)] have been available for over 50 years and the impact of this invention may not be overestimated. Today over 100 million women are current users and in Western Europe and the United States approximately 80% of women of fertile ages can be considered as ever-users. Over the years several drawbacks have been identified and media alarms on risks are frequently presented, resulting in suboptimal compliance and low compliance and continuation rates. Poor compliance and discontinuation is a big problem and is not generally identified by prescribers. During ideal use COCs offer very good protection against unwanted pregnancies, however there is a big problem with compliance and continuation and thus the 'real-life' efficacy is much lower. Reasons for poor compliance include side effects and fear of side effects and it is crucial that the prescriber gives the individual woman thorough and balanced information on the benefits and risks. Most well known is the increased risk of venous thromboembolism, but also an elevated risk of arterial thrombosis and several types of cancer has been reported. The risk estimates are low but according to the large number of users a substantial number of extra cases will occur. However, use of COCs also offers several additional health benefits with significant impact on morbidity and quality of life. COC use is associated with a substantial decrease in the risk of ovarian cancer, endometrial cancer and colorectal cancer. Moreover, COCs are a major option of treatment for women suffering from heavy menstrual bleeding and dysmenorrhea as well as hirsutism and acne vulgaris. The net effect of the additional health effects of COC- use may very well be positive, i.e. a slight increase in life expectancy.

  18. 45 CFR 160.308 - Compliance reviews.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Compliance reviews. 160.308 Section 160.308 Public... GENERAL ADMINISTRATIVE REQUIREMENTS Compliance and Investigations § 160.308 Compliance reviews. The Secretary may conduct compliance reviews to determine whether covered entities are complying with the...

  19. Spectacle Compliance among Adolescents: A Qualitative Study from Southern India.

    PubMed

    Narayanan, Anuradha; Kumar, Shuba; Ramani, Krishna Kumar

    2017-05-01

    To understand the perceptions of adolescents and their parents about spectacle compliance of adolescents in Southern India. Using a qualitative snapshot design, three focus group discussions were conducted each with parents and adolescents studying in schools located in and around Chennai, Tamil Nadu. Purposive sampling technique was used in the selection of participants. Separate focus group guides were developed for parents and adolescents. All focus group discussions were conducted in the school premises and audio recorded. These audio files were then transcribed verbatim and then translated into English. A framework analytical approach was used for data analysis that involved gaining familiarity with the data to identify a thematic framework. Two major themes that emerged were (1) perceptions on barriers to spectacle compliance that was further subdivided into physical, psychological, and societal barriers; and (2) solutions to improve spectacle use. Barriers identified included scars on the nose, unattractive frames contributing to poor appeal, adolescents feeling discriminated and set apart, fears of injury to eyes, lack of parental involvement, and negative attitudes of society toward those wearing spectacles. Solutions given by the stakeholders included provision of lightweight, well-fitting, trendy frames of adolescents' choice, importance and need for periodical eye examinations, including teachers in encouraging spectacle use and preventing bullying and teasing by other adolescents, provision of free spectacles along with periodic replacement, and inclusion of awareness sessions on spectacle use for both parents and adolescents. The study has identified both barriers and solutions for improving spectacle compliance among school adolescents from the viewpoint of the stakeholders involved. Implementing the solutions suggested by the stakeholders through planned intervention programs could possibly help in ensuring better compliance of spectacle use among

  20. Resolving the problem of compliance with the ever increasing and changing regulations

    NASA Astrophysics Data System (ADS)

    Leigh, Harley

    1992-01-01

    The most common problem identified at several U.S. Department of Energy (DOE) sites is regulatory compliance. Simply, the project viability depends on identifying regulatory requirements at the beginning of a specific project to avoid possible delays and cost overruns. The Radioisotope Power Systems Facility (RPSF) is using the Regulatory Compliance System (RCS) to deal with the problem that well over 1000 regulatory documents had to be reviewed for possible compliance requirements applicable to the facility. This overwhelming number of possible documents is not atypical of all DOE facilities thus far reviewed using the RCS system. The RCS was developed to provide control and tracking of all the regulatory and institutional requirements on a given project. WASTREN, Inc., developed the RCS through various DOE contracts and continues to enhance and update the system for existing and new contracts. The RCS provides the information to allow the technical expert to assimilate and manage accurate resource information, compile the necessary checklists, and document that the project or facility fulfills all of the appropriate regulatory requirements. The RCS provides on-line information, including status throughout the project life, thereby allowing more intelligent and proactive decision making. Also, consistency and traceability are provided for regulatory compliance documentation.

  1. Resolving the problem of compliance with the ever increasing and changing regulations

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Leigh, H.

    1991-06-01

    The most common problem identified at several US Department of Energy (DOE) sites is regulatory compliance. Simply, the project viability depends on identifying regulatory requirements at the beginning of a specific project to avoid possible delays and cost overruns. The Radioisotope Power Systems Facility (RFSP) is using the Regulatory Compliance System (RCS) to deal with the problem that well over 1000 regulatory documents had to be reviewed for possible compliance requirements applicable to the facility. This overwhelming number of possible documents is not atypical of all DOE facilities thus far reviewed using the RCS system. The RCS was developed tomore » provide a control and tracking of all the regulatory and institutional requirements on a given project. WASTREN, Inc., developed the RCS through various DOE contracts and continues to enhance and update the system for existing and new contracts. The RCS provides the information to allow the technical expert to assimilate and manage accurate resource information, compile the checklists, and document that the project or facility fulfills all of the appropriate regulatory requirements. The RCS provides on-line information, including status throughput the project life, thereby allowing more intelligent and proactive decision making. Also, consistency and traceability are provided for regulatory compliance documentation. 1 ref., 1 fig.« less

  2. 7 CFR 993.518 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 993.518 Section 993.518 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Pack Specification as to Size Compliance § 993.518 Compliance. Whenever the season average price to...

  3. 7 CFR 63.500 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Compliance. 63.500 Section 63.500 Agriculture... IMPROVEMENT CENTER General Provisions Miscellaneous § 63.500 Compliance. The Secretary shall review and monitor compliance by the Board and the NSIIC with the Act and this part. ...

  4. 44 CFR 206.402 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Compliance. 206.402 Section... HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE Minimum Standards § 206.402 Compliance. A... compliance with this subpart following the completion of any repair or construction activities. ...

  5. 5 CFR 2424.41 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Compliance. 2424.41 Section 2424.41... FEDERAL LABOR RELATIONS AUTHORITY NEGOTIABILITY PROCEEDINGS Decision and Order § 2424.41 Compliance. The... compliance with its order, including enforcement under 5 U.S.C. 7123(b). ...

  6. 5 CFR 2424.41 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Compliance. 2424.41 Section 2424.41... FEDERAL LABOR RELATIONS AUTHORITY NEGOTIABILITY PROCEEDINGS Decision and Order § 2424.41 Compliance. The... compliance with its order, including enforcement under 5 U.S.C. 7123(b). ...

  7. 7 CFR 959.81 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 959.81 Section 959.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Compliance § 959.81 Compliance. Except as provided in this subpart, no handler shall...

  8. 44 CFR 206.402 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Compliance. 206.402 Section... HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE Minimum Standards § 206.402 Compliance. A... compliance with this subpart following the completion of any repair or construction activities. ...

  9. 7 CFR 959.81 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 959.81 Section 959.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Compliance § 959.81 Compliance. Except as provided in this subpart, no handler shall...

  10. 7 CFR 993.518 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 993.518 Section 993.518 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Pack Specification as to Size Compliance § 993.518 Compliance. Whenever the season average price to...

  11. 7 CFR 948.81 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 948.81 Section 948.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Compliance § 948.81 Compliance. Except as provided in this subpart, no handler...

  12. 40 CFR 720.120 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Compliance. 720.120 Section 720.120 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT PREMANUFACTURE NOTIFICATION Compliance and Inspections § 720.120 Compliance. (a) Failure to comply with any...

  13. 7 CFR 948.81 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 948.81 Section 948.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Compliance § 948.81 Compliance. Except as provided in this subpart, no handler...

  14. 40 CFR 720.120 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Compliance. 720.120 Section 720.120 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT PREMANUFACTURE NOTIFICATION Compliance and Inspections § 720.120 Compliance. (a) Failure to comply with any...

  15. 15 CFR 700.75 - Compliance conflicts.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Compliance conflicts. 700.75 Section... DEFENSE PRIORITIES AND ALLOCATIONS SYSTEM Compliance § 700.75 Compliance conflicts. If compliance with any... notify the Department of Commerce for resolution of the conflict. [49 FR 30414, July 30, 1984...

  16. 10 CFR 850.13 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Compliance. 850.13 Section 850.13 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Administrative Requirements § 850.13 Compliance. (a) The responsible employer must conduct activities in compliance with its CBDPP. (b) The responsible...

  17. 10 CFR 850.13 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Compliance. 850.13 Section 850.13 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Administrative Requirements § 850.13 Compliance. (a) The responsible employer must conduct activities in compliance with its CBDPP. (b) The responsible...

  18. 77 FR 64374 - Petition for Waiver of Compliance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... internal safety audits to evaluate compliance with SSPP and measure its effectiveness. An annual report identifying the audits performed and any corrective action must be submitted to the New Jersey Department of... audit. In addition, NJDOT conducts a safety review a minimum of once every 3 years to evaluate the...

  19. Obesity educational interventions in U.S. medical schools: a systematic review and identified gaps.

    PubMed

    Vitolins, Mara Z; Crandall, Sonia; Miller, David; Ip, Eddie; Marion, Gail; Spangler, John G

    2012-01-01

    Obesity is the second leading cause of preventable death in the United States. However, physicians feel poorly trained to address the obesity epidemic. This article examines effective training methods for overweight and obesity intervention in undergraduate medical education. Using indexing terms related to overweight, obesity, and medical student education, we conducted a literature searched PubMed PsycINFO, Cochrane, and ERIC for relevant articles in English. References from articles identified were also reviewed to located additional articles. We included all studies that incorporated process or outcome evaluations of obesity educational interventions for U.S. medical students. Of an initial 168 citations, 40 abstracts were retrieved; 11 studies were found to be pertinent to medical student obesity education, but only 5 included intervention and evaluation elements. Quality criteria for inclusion consisted of explicit evaluation of the educational methods used. Data extraction identified participants (e.g., year of medical students), interventions, evaluations, and results. These 5 studies successfully used a variety of teaching methods including hands on training, didactic lectures, role-playing, and standardized patient interaction to increase medical students' knowledge, attitudes, and skills regarding overweight and obesity intervention. Two studies addressed medical student bias toward overweight and obese patients. No studies addressed health disparities in the epidemiology and bias of obesity. Despite the commonly cited "obesity epidemic," there are very few published studies that report the effectiveness of medical school obesity educational programs. Gaps still exist within undergraduate medical education including specific training that addresses obesity and long-term studies showing that such training is retained.

  20. 34 CFR 110.30 - Compliance reviews.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Compliance reviews. 110.30 Section 110.30 Education..., Conciliation, and Enforcement Procedures § 110.30 Compliance reviews. (a) ED may conduct compliance reviews... these regulations occurred. (b) If a compliance review or pre-award review indicates a violation of the...

  1. 45 CFR 1156.14 - Compliance reviews.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance reviews. 1156.14 Section 1156.14 Public..., and Enforcement Procedures § 1156.14 Compliance reviews. The Endowment may conduct compliance reviews... recipient. In the event a compliance review or pre-award review indicates a violation of the regulations in...

  2. 40 CFR 1507.1 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Compliance. 1507.1 Section 1507.1 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY AGENCY COMPLIANCE § 1507.1 Compliance. All agencies of the Federal Government shall comply with these regulations. It is the intent of these...

  3. 40 CFR 1507.1 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Compliance. 1507.1 Section 1507.1 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY AGENCY COMPLIANCE § 1507.1 Compliance. All agencies of the Federal Government shall comply with these regulations. It is the intent of these...

  4. 5 CFR 900.604 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Compliance. 900.604 Section 900.604... Compliance. (a) Certification by Chief Executives. (1) Certification of agreement by a chief executive of a... of certification by the chief executive, compliance with the Standards may be certified by the heads...

  5. 31 CFR 208.9 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Compliance. 208.9 Section 208.9 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT... Compliance. (a) Treasury will monitor agencies' compliance with this part. Treasury may require agencies to...

  6. 7 CFR 772.3 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 7 2011-01-01 2011-01-01 false Compliance. 772.3 Section 772.3 Agriculture... SPECIAL PROGRAMS SERVICING MINOR PROGRAM LOANS § 772.3 Compliance. (a) Requirements. No Minor Program... will conduct a compliance review of all Minor Program borrowers, to determine if a borrower has...

  7. 7 CFR 16.5 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 1 2011-01-01 2011-01-01 false Compliance. 16.5 Section 16.5 Agriculture Office of the Secretary of Agriculture EQUAL OPPORTUNITY FOR RELIGIOUS ORGANIZATIONS § 16.5 Compliance. USDA agencies will monitor compliance with this part in the course of regular oversight of USDA programs. ...

  8. 36 CFR 223.13 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Compliance. 223.13 Section... OF NATIONAL FOREST SYSTEM TIMBER General Provisions § 223.13 Compliance. Forest officers authorizing free use shall ensure that such use is in compliance with applicable land management plans and is...

  9. 40 CFR 73.35 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Compliance. 73.35 Section 73.35... ALLOWANCE SYSTEM Allowance Tracking System § 73.35 Compliance. (a) Allowance transfer deadline. No allowance shall be deducted for purposes of compliance with an affected source's sulfur dioxide Acid Rain...

  10. 15 CFR 700.7 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 2 2011-01-01 2011-01-01 false Compliance. 700.7 Section 700.7 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF... PRIORITIES AND ALLOCATIONS SYSTEM Overview § 700.7 Compliance. (a) Compliance with the provisions of this...

  11. 5 CFR 900.604 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Compliance. 900.604 Section 900.604... Compliance. (a) Certification by Chief Executives. (1) Certification of agreement by a chief executive of a... of certification by the chief executive, compliance with the Standards may be certified by the heads...

  12. 7 CFR 16.5 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Compliance. 16.5 Section 16.5 Agriculture Office of the Secretary of Agriculture EQUAL OPPORTUNITY FOR RELIGIOUS ORGANIZATIONS § 16.5 Compliance. USDA agencies will monitor compliance with this part in the course of regular oversight of USDA programs. ...

  13. 31 CFR 208.9 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Compliance. 208.9 Section 208.9 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT... Compliance. (a) Treasury will monitor agencies' compliance with this part. Treasury may require agencies to...

  14. 7 CFR 772.3 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Compliance. 772.3 Section 772.3 Agriculture... SPECIAL PROGRAMS SERVICING MINOR PROGRAM LOANS § 772.3 Compliance. (a) Requirements. No Minor Program... will conduct a compliance review of all Minor Program borrowers, to determine if a borrower has...

  15. 40 CFR 73.35 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Compliance. 73.35 Section 73.35... ALLOWANCE SYSTEM Allowance Tracking System § 73.35 Compliance. (a) Allowance transfer deadline. No allowance shall be deducted for purposes of compliance with an affected source's sulfur dioxide Acid Rain...

  16. 15 CFR 700.7 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Compliance. 700.7 Section 700.7 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF... PRIORITIES AND ALLOCATIONS SYSTEM Overview § 700.7 Compliance. (a) Compliance with the provisions of this...

  17. 42 CFR 488.26 - Determining compliance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Determining compliance. 488.26 Section 488.26... § 488.26 Determining compliance. (a) Additional rules for certification of compliance for SNFs and NFs are set forth in § 488.330. (b) The decision as to whether there is compliance with a particular...

  18. 45 CFR 91.41 - Compliance reviews.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Compliance reviews. 91.41 Section 91.41 Public..., Conciliation, and Enforcement Procedures § 91.41 Compliance reviews. (a) HHS may conduct compliance reviews and... the Act and these regulations has occurred. (b) If a compliance review or pre-award review indicates a...

  19. The Impact of Internet Health Information on Patient Compliance: A Research Model and an Empirical Study.

    PubMed

    Laugesen, John; Hassanein, Khaled; Yuan, Yufei

    2015-06-11

    compared to the impact that Internet health information quality has on these same variables. The findings also indicate that agreement between the patient and physician on the medical situation and treatment is much more important to compliance than the perceived information gap between the patient and physician (ie, the physician having a higher level of information in comparison to the patient). In addition, the level of agreement between a patient and their physician regarding the medical situation is more reliant on the perceived quality of their physician than on the perceived quality of Internet health information used. This research found that only the perceived quality of the physician has a significant relationship with the perceived information gap between the patient and their physician and the quality of the Internet health information has no relationship with this perceived information gap.

  20. The Impact of Internet Health Information on Patient Compliance: A Research Model and an Empirical Study

    PubMed Central

    Hassanein, Khaled; Yuan, Yufei

    2015-01-01

    patient’s compliance with their physician’s advice when compared to the impact that Internet health information quality has on these same variables. The findings also indicate that agreement between the patient and physician on the medical situation and treatment is much more important to compliance than the perceived information gap between the patient and physician (ie, the physician having a higher level of information in comparison to the patient). In addition, the level of agreement between a patient and their physician regarding the medical situation is more reliant on the perceived quality of their physician than on the perceived quality of Internet health information used. This research found that only the perceived quality of the physician has a significant relationship with the perceived information gap between the patient and their physician and the quality of the Internet health information has no relationship with this perceived information gap. PMID:26068214

  1. Microprocessor controlled compliance monitor for eye drop medication

    PubMed Central

    Hermann, M M; Diestelhorst, M

    2006-01-01

    Background/aims The effectiveness of a self administered eye drop medication can only be assessed if the compliance is known. The authors studied the specificity and sensitivity of a new microprocessor controlled monitoring device. Methods The monitoring system was conducted by an 8 bit microcontroller for data acquisition and storage with sensors measuring applied pressure to the bottle, temperature, and vertical position. 10 devices were mounted under commercial 10 ml eye drops. Test subjects had to note down each application manually. A total of 15 applications each within 3 days was intended. Results Manual reports confirmed 15 applications for each of the 10 bottles. The monitoring devices detected a total of 149 events; one was missed; comprising a sensitivity of 99%. Two devices registered three applications, which did not appear in the manual protocols, indicating a specificity of about 98%. Refrigerated bottles were correctly identified. The battery lifetime exceeded 60 days. Conclusion The new monitoring device demonstrated a high reliability of the collected compliance data. The important, yet often unknown, influence of compliance in patient care and clinical trials shall be illuminated by the new device. This may lead to a better adapted patient care. Studies will profit from a higher credibility and results will be less influenced by non‐compliance. PMID:16540488

  2. Narrowing the Achievement Gap: A Case Study of an Urban School

    ERIC Educational Resources Information Center

    Lugo, Rosalinda

    2010-01-01

    The goal of this case study was to identify the cultural norms, practices, and programs of an urban school that narrowed the achievement gap. The reason for identifying these factors in a successful school was to add to the body of literature regarding the achievement gap and what a struggling school was able to do to narrow the gap. This case…

  3. 40 CFR 469.21 - Compliance dates.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Compliance dates. 469.21 Section 469....21 Compliance dates. The compliance date for the BAT fluoride limitation is as soon as possible as determined by the permit writer but in no event later than November 8, 1985. The compliance date for PSES for...

  4. 40 CFR 469.21 - Compliance dates.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Compliance dates. 469.21 Section 469....21 Compliance dates. The compliance date for the BAT fluoride limitation is as soon as possible as determined by the permit writer but in no event later than November 8, 1985. The compliance date for PSES for...

  5. 45 CFR 617.7 - Compliance reviews.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance reviews. 617.7 Section 617.7 Public... Compliance reviews. (a) NSF may conduct compliance reviews of recipients that will permit it to investigate... the Act has occurred. (b) If a compliance review indicates a violation of the Act, NSF will attempt to...

  6. 43 CFR 3102.5-1 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Compliance. 3102.5-1 Section 3102.5-1...-1 Compliance. In order to actually or potentially own, hold, or control an interest in a lease or... partnerships of all types, shall, without exception, be qualified and in compliance with the act. Compliance...

  7. 42 CFR 124.503 - Compliance level.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Compliance level. 124.503 Section 124.503 Public... Unable To Pay § 124.503 Compliance level. (a) Annual compliance level. Subject to the provisions of this subpart, a facility is in compliance with its assurance to provide a reasonable volume of services to...

  8. 10 CFR 434.509 - Compliance.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Compliance. 434.509 Section 434.509 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.509 Compliance. 509.1If the Design Energy Cost...

  9. 10 CFR 434.509 - Compliance.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Compliance. 434.509 Section 434.509 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.509 Compliance. 509.1 If the Design Energy Cost...

  10. 10 CFR 434.509 - Compliance.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Compliance. 434.509 Section 434.509 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.509 Compliance. 509.1If the Design Energy Cost...

  11. 10 CFR 851.13 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Compliance. 851.13 Section 851.13 Energy DEPARTMENT OF ENERGY WORKER SAFETY AND HEALTH PROGRAM Program Requirements § 851.13 Compliance. (a) Contractors must achieve compliance with all the requirements of Subpart C of this part, and their approved worker safety...

  12. 33 CFR 104.115 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Compliance. 104.115 Section 104... MARITIME SECURITY: VESSELS General § 104.115 Compliance. (a) Vessel owners or operators must ensure their vessels are operating in compliance with this part. (b) Owners or operators of foreign vessels must comply...

  13. 10 CFR 434.509 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Compliance. 434.509 Section 434.509 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.509 Compliance. 509.1If the Design Energy Cost...

  14. 14 CFR 25.1207 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Compliance. 25.1207 Section 25.1207... STANDARDS: TRANSPORT CATEGORY AIRPLANES Powerplant Powerplant Fire Protection § 25.1207 Compliance. Unless otherwise specified, compliance with the requirements of §§ 25.1181 through 25.1203 must be shown by a full...

  15. 24 CFR 200.635 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Compliance. 200.635 Section 200.635... GENERAL INTRODUCTION TO FHA PROGRAMS Affirmative Fair Housing Marketing Regulations § 200.635 Compliance... Department will enforce compliance through the procedures outlined in 24 CFR part 108. [37 FR 75, Jan. 5...

  16. 24 CFR 200.635 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Compliance. 200.635 Section 200.635... GENERAL INTRODUCTION TO FHA PROGRAMS Affirmative Fair Housing Marketing Regulations § 200.635 Compliance... Department will enforce compliance through the procedures outlined in 24 CFR part 108. [37 FR 75, Jan. 5...

  17. 14 CFR 417.203 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Compliance. 417.203 Section 417.203... TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.203 Compliance. (a) General. A launch... need for further demonstration of compliance to the FAA, if: (1) A launch operator has contracted with...

  18. 49 CFR 663.15 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Compliance. 663.15 Section 663.15 Transportation... TRANSPORTATION PRE-AWARD AND POST-DELIVERY AUDITS OF ROLLING STOCK PURCHASES General § 663.15 Compliance. A recipient subject to this part shall comply with all applicable requirements of this part. Such compliance...

  19. 14 CFR 25.1207 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Compliance. 25.1207 Section 25.1207... STANDARDS: TRANSPORT CATEGORY AIRPLANES Powerplant Powerplant Fire Protection § 25.1207 Compliance. Unless otherwise specified, compliance with the requirements of §§ 25.1181 through 25.1203 must be shown by a full...

  20. 33 CFR 104.115 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Compliance. 104.115 Section 104... MARITIME SECURITY: VESSELS General § 104.115 Compliance. (a) Vessel owners or operators must ensure their vessels are operating in compliance with this part. (b) Owners or operators of foreign vessels must comply...

  1. 7 CFR 945.70 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 945.70 Section 945.70 Agriculture... DESIGNATED COUNTIES IN IDAHO, AND MALHEUR COUNTY, OREGON Order Regulating Handling Compliance § 945.70 Compliance. Except as provided in this part, no handler shall ship potatoes, the shipment of which has been...

  2. 36 CFR 223.13 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Compliance. 223.13 Section... Provisions § 223.13 Compliance. Forest officers authorizing free use shall ensure that such use is in compliance with applicable land management plans and is conducted in a manner which protects National Forest...

  3. 10 CFR 434.509 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Compliance. 434.509 Section 434.509 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CODE FOR NEW FEDERAL COMMERCIAL AND MULTI-FAMILY HIGH RISE RESIDENTIAL BUILDINGS Building Energy Cost Compliance Alternative § 434.509 Compliance. 509.1If the Design Energy Cost...

  4. 7 CFR 945.70 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 945.70 Section 945.70 Agriculture... DESIGNATED COUNTIES IN IDAHO, AND MALHEUR COUNTY, OREGON Order Regulating Handling Compliance § 945.70 Compliance. Except as provided in this part, no handler shall ship potatoes, the shipment of which has been...

  5. 10 CFR 851.13 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Compliance. 851.13 Section 851.13 Energy DEPARTMENT OF ENERGY WORKER SAFETY AND HEALTH PROGRAM Program Requirements § 851.13 Compliance. (a) Contractors must achieve compliance with all the requirements of Subpart C of this part, and their approved worker safety...

  6. 49 CFR 663.15 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Compliance. 663.15 Section 663.15 Transportation... TRANSPORTATION PRE-AWARD AND POST-DELIVERY AUDITS OF ROLLING STOCK PURCHASES General § 663.15 Compliance. A recipient subject to this part shall comply with all applicable requirements of this part. Such compliance...

  7. 14 CFR 417.203 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Compliance. 417.203 Section 417.203... TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.203 Compliance. (a) General. A launch... need for further demonstration of compliance to the FAA, if: (1) A launch operator has contracted with...

  8. 40 CFR 63.772 - Test methods, compliance procedures, and compliance demonstrations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Oil and Natural Gas Production Facilities § 63.772 Test methods, compliance procedures, and compliance...) A mixture of methane in air at a concentration less than 10,000 parts per million by volume. (5) An... methane and ethane) or total HAP (Ei, Eo) shall be computed using the equations and procedures specified...

  9. 40 CFR 63.772 - Test methods, compliance procedures, and compliance demonstrations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Oil and Natural Gas Production Facilities § 63.772 Test methods, compliance procedures, and compliance...) A mixture of methane in air at a concentration less than 10,000 parts per million by volume. (5) An... rate of either TOC (minus methane and ethane) or total HAP (Ei, Eo) shall be computed using the...

  10. 40 CFR 63.772 - Test methods, compliance procedures, and compliance demonstrations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Oil and Natural Gas Production Facilities § 63.772 Test methods, compliance procedures, and compliance...) A mixture of methane in air at a concentration less than 10,000 parts per million by volume. (5) An... methane and ethane) or total HAP (Ei, Eo) shall be computed using the equations and procedures specified...

  11. 40 CFR 63.772 - Test methods, compliance procedures, and compliance demonstrations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Oil and Natural Gas Production Facilities § 63.772 Test methods, compliance procedures, and compliance...) A mixture of methane in air at a concentration less than 10,000 parts per million by volume. (5) An... rate of either TOC (minus methane and ethane) or total HAP (Ei, Eo) shall be computed using the...

  12. 45 CFR 98.91 - Non-compliance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Non-compliance. 98.91 Section 98.91 Public Welfare..., Non-compliance and Complaints § 98.91 Non-compliance. (a) If after reasonable notice to a Lead Agency... the Lead Agency a written notice of a finding of non-compliance. This notice will be issued within 60...

  13. Mobile App to Assess Universal Access Compliance.

    PubMed

    Fransolet, Colette

    2016-01-01

    In terms of local legislation, South Africa has a handful of regulations that indirectly require Universal Access, which is then in itself largely described as facilities for people with disabilities. The most predominant set of regulations is the South African National Building Regulations, with a specific code which is deemed to satisfy standard titled South African National Standard (SANS) 10400 Part S: Facilities for Persons with Disabilities. Revised in 2011, this building regulation offers some technical guidelines specific to built infrastructure, and largely for people with functional mobility limitations. The description of the term "functional mobility limitations" in the context of this paper refers to people who make use of mobility aids to assist with their functionality in an environment, for example people who use walking aids (sticks, canes or walkers) and people who use wheelchairs. Albeit lacking in specifics around the requirements for other areas of functional limitations, including people who are blind, people who are deaf, and people with cognitive limitations, the SANS 10400 Part S is, to date, the most effective regulatory requirement in the country to assist with making facilities more accessible. With only a few experts in South Africa working in the field, the ability to offer clients Universal Access Reviews in terms of basic compliance with the SANS 10400 Part S is limited by two major factors. Firstly, the costs associated with employing experts in the field to review infrastructure is mostly too exorbitant for clients to carry. Secondly, the amount of time taken to perform reviews onsite and then collate the information into a coherent report for the client is far too long. These aspects result in a gap between clients wanting to meet the requirements, and being able to have the work completed in a reasonable amount of time. To overcome the challenge of larger institutions and organizations wanting to have their facilities reviewed in

  14. Copyright Compliance Program.

    ERIC Educational Resources Information Center

    Jones, Robert P.

    The policy and position of the University of Northern Florida's library for compliance with the newly revised Copyright Law of January 1978 is reflected in this document, which serves as official notice to and protection of the library's employees in regard to the law. Summaries of provisions and requirements of the law and methods of compliance,…

  15. Gap-junctional channel and hemichannel activity of two recently identified connexin 26 mutants associated with deafness.

    PubMed

    Dalamon, Viviana; Fiori, Mariana C; Figueroa, Vania A; Oliva, Carolina A; Del Rio, Rodrigo; Gonzalez, Wendy; Canan, Jonathan; Elgoyhen, Ana B; Altenberg, Guillermo A; Retamal, Mauricio A

    2016-05-01

    Gap-junction channels (GJCs) are formed by head-to-head association of two hemichannels (HCs, connexin hexamers). HCs and GJCs are permeable to ions and hydrophilic molecules of up to Mr ~1 kDa. Hearing impairment of genetic origin is common, and mutations of connexin 26 (Cx26) are its major cause. We recently identified two novel Cx26 mutations in hearing-impaired subjects, L10P and G109V. L10P forms functional GJCs with slightly altered voltage dependence and HCs with decrease ATP/cationic dye selectivity. G109V does not form functional GJCs, but forms functional HCs with enhanced extracellular Ca(2+) sensitivity and subtle alterations in voltage dependence and ATP/cationic dye selectivity. Deafness associated with G109V could result from decreased GJCs activity, whereas deafness associated to L10P may have a more complex mechanism that involves changes in HC permeability.

  16. 14 CFR 417.402 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Compliance. 417.402 Section 417.402... TRANSPORTATION LICENSING LAUNCH SAFETY Ground Safety § 417.402 Compliance. (a) General. A launch operator's... of compliance to the FAA if: (1) A launch operator has contracted with a Federal launch range for the...

  17. 10 CFR 2.1012 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Compliance. 2.1012 Section 2.1012 Energy NUCLEAR... Geologic Repository § 2.1012 Compliance. (a) If the Department of Energy fails to make its initial... storage media in a format consistent with NRC regulations and guidance, or for non-compliance with any...

  18. 40 CFR 96.54 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Compliance. 96.54 Section 96.54... Tracking System § 96.54 Compliance. (a) NO X allowance transfer deadline. The NOX allowances are available to be deducted for compliance with a unit's NOX Budget emissions limitation for a control period in a...

  19. 40 CFR 97.54 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Compliance. 97.54 Section 97.54... Compliance. (a) NOX allowance transfer deadline. The NOX allowances are available to be deducted for compliance with a unit's NOX Budget emissions limitation for a control period in a given year only if the NOX...

  20. 7 CFR 15.5 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Compliance. 15.5 Section 15.5 Agriculture Office of... Department of Agriculture-Effectuation of Title VI of the Civil Rights Act of 1964 § 15.5 Compliance. (a... recipients in obtaining compliance with the regulations and this part and shall provide assistance and...

  1. 40 CFR 129.5 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Compliance. 129.5 Section 129.5... STANDARDS Toxic Pollutant Effluent Standards and Prohibitions § 129.5 Compliance. (a)(1) Within 60 days from... standard established for any particular pollutant. (d)(1) Upon the compliance date for any section 307(a...

  2. 40 CFR 129.5 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Compliance. 129.5 Section 129.5... STANDARDS Toxic Pollutant Effluent Standards and Prohibitions § 129.5 Compliance. (a)(1) Within 60 days from... standard established for any particular pollutant. (d)(1) Upon the compliance date for any section 307(a...

  3. 14 CFR 417.402 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Compliance. 417.402 Section 417.402... TRANSPORTATION LICENSING LAUNCH SAFETY Ground Safety § 417.402 Compliance. (a) General. A launch operator's... of compliance to the FAA if: (1) A launch operator has contracted with a Federal launch range for the...

  4. 7 CFR 15.5 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 1 2011-01-01 2011-01-01 false Compliance. 15.5 Section 15.5 Agriculture Office of... Department of Agriculture-Effectuation of Title VI of the Civil Rights Act of 1964 § 15.5 Compliance. (a... recipients in obtaining compliance with the regulations and this part and shall provide assistance and...

  5. 40 CFR 97.54 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Compliance. 97.54 Section 97.54... Compliance. (a) NOX allowance transfer deadline. The NOX allowances are available to be deducted for compliance with a unit's NOX Budget emissions limitation for a control period in a given year only if the NOX...

  6. 45 CFR 1356.85 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Compliance. 1356.85 Section 1356.85 Public Welfare....85 Compliance. (a) File submission standards. A State agency must submit a data file in accordance... compliance. (1) ACF will determine whether a State agency's data file for each reporting period is in...

  7. 40 CFR 96.54 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Compliance. 96.54 Section 96.54... Tracking System § 96.54 Compliance. (a) NO X allowance transfer deadline. The NOX allowances are available to be deducted for compliance with a unit's NOX Budget emissions limitation for a control period in a...

  8. 45 CFR 1356.85 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Compliance. 1356.85 Section 1356.85 Public Welfare....85 Compliance. (a) File submission standards. A State agency must submit a data file in accordance... compliance. (1) ACF will determine whether a State agency's data file for each reporting period is in...

  9. Article: Next Generation Compliance

    EPA Pesticide Factsheets

    The article Next Generation Compliance by Cynthia Giles, Assistant Administrator for OECA was published in The Environmental Forum, Sept-Oct 2013 explains EPA's strategy on using new technologies to improve compliance with environmental laws.

  10. A systematic review of compliance with palivizumab administration for RSV immunoprophylaxis.

    PubMed

    Frogel, Michael P; Stewart, Dan L; Hoopes, Michael; Fernandes, Ancilla W; Mahadevia, Parthiv J

    2010-01-01

    Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection (LRTI) in infants and young children, accounting for approximately 75,000-125,000 hospitalizations per year. It is estimated that in 2000, RSV infection accounted for 1.7 million office visits, 402,000 emergency room visits, and 236,000 hospital outpatient visits per year for children younger than 5 years of age. Palivizumab, a humanized monoclonal antibody directed against RSV, is the only immunoprophylaxis therapy approved by the FDA for prevention of serious lower respiratory tract disease caused by RSV in infants (up to 2 years of age) who meet 1 or more of the following criteria for high risk: (a) gestational age up to 35 weeks;(b) diagnosis of chronic lung disease (CLD, formerly bronchopulmonary dysplasia [BPD]); or (c) diagnosis of cyanotic or complex congenital heart disease. The RSV season typically occurs between November and March but may vary by region. During the period of our review, depending on local duration of the RSV season, infants usually required 5 monthly (every 28-30 days) intramuscular injections of palivizumab. Infants born in the middle of the season received their palivizumab doses from the time of birth to the end of the season and, therefore, may have required less than 5 doses.It is unclear if compliance with monthly doses is a problem and whether noncompliance increases the risk of RSV hospitalizations in routine clinical practice. To (a) identify and describe compliance rates and the factors that influence parental compliance with immunoprophylaxis regimens, (b)review intervention programs and describe those that have been associated with increased compliance, and (c) summarize the association of compliance with RSV hospitalization rates. An electronic literature search was conducted using journal databases, including Ovid, Current Contents, Embase, Medline In-Process & Other Non-Indexed Citations; Ovid Medline, PubMed, and Web of Science

  11. Detecting sign-changing superconducting gap in LiFeAs using quasiparticle interference

    NASA Astrophysics Data System (ADS)

    Altenfeld, D.; Hirschfeld, P. J.; Mazin, I. I.; Eremin, I.

    2018-02-01

    Using a realistic ten-orbital tight-binding model Hamiltonian fitted to the angle-resolved photoemission spectroscopy data on LiFeAs, we analyze the temperature, frequency, and momentum dependencies of quasiparticle interference to identify gap sign changes in a qualitative way, following our original proposal [Phys. Rev. B 92, 184513 (2015), 10.1103/PhysRevB.92.184513]. We show that all features present for the simple two-band model for the sign-changing s+--wave superconducting gap employed previously are still present in the realistic tight-binding approximation and gap values observed experimentally. We discuss various superconducting gap structures proposed for LiFeAs and identify various features of these superconducting gap functions in the quasiparticle interference patterns. On the other hand, we show that it will be difficult to identify the more complicated possible sign structures of the hole pocket gaps in LiFeAs due to the smallness of the pockets and the near proximity of two of the gap energies.

  12. Non-compliance with pharmacotherapy of depression is associated with a sensation seeking personality.

    PubMed

    Ekselius, L; Bengtsson, F; von Knorring, L

    2000-09-01

    Inadequate compliance of drug intake is an important cause of ineffective pharmacotherapy and has been associated with therapeutic failure. We hypothesized that sensation seeking personality traits would affect compliance with long-term antidepressant medication. Three hundred and eight depressed patients participating in a randomized double-blind study of sertraline and citalopram were included. Personality traits were assessed using the Karolinska Scales of Personality. Compliance to medication was determined in two ways, by means of tablet counting and by measurement concentration of drug in serum. Tablet non-compliance was defined as less than 80% or more than 100% intake of the prescribed drug during weeks 20-24. Serum drug non-compliance was defined as undetectable amounts of either drug and main metabolite in the serum samples at week 24. Two virtually not overlapping groups of non-compliant patients were identified, where those regarded as non-compliant due to the interpretation of the serum drug levels were in majority. The group of serum drug non-compliant patients were recognized by significantly higher scores on the Monotony Avoidance scale and the Impulsive Sensation Seeking Psychopathy factor. The need for better methods than tablet counting and patient questioning to ascertain compliance is emphasized.

  13. A prototype home robot with an ambient facial interface to improve drug compliance.

    PubMed

    Takacs, Barnabas; Hanak, David

    2008-01-01

    We have developed a prototype home robot to improve drug compliance. The robot is a small mobile device, capable of autonomous behaviour, as well as remotely controlled operation via a wireless datalink. The robot is capable of face detection and also has a display screen to provide facial feedback to help motivate patients and thus increase their level of compliance. An RFID reader can identify tags attached to different objects, such as bottles, for fluid intake monitoring. A tablet dispenser allows drug compliance monitoring. Despite some limitations, experience with the prototype suggests that simple and low-cost robots may soon become feasible for care of people living alone or in isolation.

  14. Contingent Access to Preferred Items versus a Guided Compliance Procedure to Increase Compliance among Preschoolers

    ERIC Educational Resources Information Center

    Wilder, David A.; Saulnier, Renee; Beavers, Gracie; Zonneveld, Kimberley

    2008-01-01

    Noncompliance with instructions is among the most common behavior problems exhibited by preschoolers. Although three-step guidance compliance procedures have been shown to be effective to increase compliance among some children, they may require that a child be exposed to a number of trials before compliance begins to increase. In this study, a…

  15. ICIS FE&C Compliance Monitoring Screens

    EPA Pesticide Factsheets

    Web Based Training for Integrated Compliance Information System Updated Compliance Monitoring Training for ICIS Federal Enforcement and Compliance User. This training goes through the changes in the screens for the application.

  16. Tuberculosis in the workplace: OSHA's compliance experience.

    PubMed

    McDiarmid, M; Gamponia, M J; Ryan, M A; Hirshon, J M; Gillen, N A; Cox, M

    1996-03-01

    Inspections of 272 facilities were performed between May 1992 and October 1994 to determine compliance with applicable Occupational Safety and Health Administration (OSHA) requirements for prevention of tuberculosis (TB) transmission. Retrospective record review of two data sources: (1) OSHA's Computerized Integrated Management Information System and (2) an inspector-completed questionnaire on inspection results. Inspections of five types of facilities: healthcare institutions, correctional facilities, homeless shelters, long-term-care facilities for the elderly, and others, including drug treatment centers that the Centers for Disease Control and Prevention (CDC) identified as having a higher than expected rate of TB. The OSHA Compliance Memorandum, based on the 1990 CDC Guidelines, which outlined elements of a TB prevention program, was used in performing 272 inspections of facilities between May 1992 and October 1994. Elements of compliance were recorded and reviewed from the IMIS database and inspectors' questionnaires. Regulated facilities were not fully compliant with OSHA guidance. Generally, healthcare facilities performed better than other facilities. Most facilities (79%) were compliant with administrative elements of a comprehensive TB control program, such as early identification of known or suspected infectious TB patients and skin testing of workers. Only 29% of inspected facilities were found to have acceptable respiratory protection programs for the prevention of occupational TB. Facilities have not been fully compliant with the OSHA memorandum describing protection of workers from TB. Facility compliance was better with some traditionally recognized TB infection control elements, but was weaker in the area of respiratory protection programs. This may reflect a lack of familiarity with the latter type of hazard protection.

  17. 5 CFR 304.108 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Compliance. 304.108 Section 304.108... APPOINTMENTS § 304.108 Compliance. (a) Each agency using 5 U.S.C. 3109 must establish and maintain a system of controls and oversight necessary to assure compliance with 5 U.S.C. 3109 and these regulations. The system...

  18. 5 CFR 304.108 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Compliance. 304.108 Section 304.108... APPOINTMENTS § 304.108 Compliance. (a) Each agency using 5 U.S.C. 3109 must establish and maintain a system of controls and oversight necessary to assure compliance with 5 U.S.C. 3109 and these regulations. The system...

  19. GAP Analysis Bulletin Number 15

    USGS Publications Warehouse

    Maxwell, Jill; Gergely, Kevin; Aycrigg, Jocelyn; Canonico, Gabrielle; Davidson, Anne; Coffey, Nicole

    2008-01-01

    The Mission of the Gap Analysis Program (GAP) is to promote conservation by providing broad geographic information on biological diversity to resource managers, planners, and policy makers who can use the information to make informed decisions. As part of the National Biological Information Infrastructure (NBII) ?a collaborative program to provide increased access to data and information on the nation?s biological resources--GAP data and analytical tools have been used in hundreds of applications: from basic research to comprehensive state wildlife plans; from educational projects in schools to ecoregional assessments of biodiversity. The challenge: keeping common species common means protecting them BEFORE they become threatened. To do this on a state or regional basis requires key information such as land cover descriptions, predicted distribution maps for native animals, and an assessment of the level of protection currently given to those plants and animals. GAP works cooperatively with Federal, state, and local natural resource professionals and academics to provide this kind of information. GAP activities focus on the creation of state and regional databases and maps that depict patterns of land management, land cover, and biodiversity. These data can be used to identify ?gaps? in conservation--instances where an animal or plant community is not adequately represented on the existing network of conservation lands. GAP is administered through the U.S. Geological Survey. Through building partnerships among disparate groups, GAP hopes to foster the kind of collaboration that is needed to address conservation issues on a broad scale. For more information, contact: John Mosesso National GAP Director 703-648-4079 Kevin Gergely National GAP Operations Manager 208-885-3565

  20. Analysing compliance of cigarette packaging with the FCTC and national legislation in eight former Soviet countries.

    PubMed

    Mir, Hassan; Roberts, Bayard; Richardson, Erica; Chow, Clara; McKee, Martin

    2013-07-01

    To analyse compliance of cigarette packets with the Framework Convention on Tobacco Control (FCTC) and national legislation and the policy actions that are required in eight former Soviet Union countries. We obtained cigarette packets of each of the 10 most smoked cigarette brands in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Moldova, Russia and Ukraine. The packets were then analysed using a standardised data collection instrument. The analysis included the placing, size and content of health warning labels and deceptive labels (eg, 'Lights'). Findings were assessed for compliance with the FCTC and national legislation. Health warnings were on all packets from all countries and met the FCTC minimum recommendations on size and position except Azerbaijan and Georgia. All countries used a variety of warnings except Azerbaijan. No country had pictorial health warnings, despite them being mandatory in Georgia and Moldova. All of the countries had deceptive labels despite being banned in all countries except Russia and Azerbaijan where still no such legislation exists. Despite progress in the use of health warning messages, gaps still remain-particularly with the use of deceptive labels. Stronger surveillance and enforcement mechanisms are required to improve compliance with the FCTC and national legislation.

  1. Policy compliance of smokers on a tobacco-free university campus.

    PubMed

    Russette, Helen C; Harris, Kari Jo; Schuldberg, David; Green, Linda

    2014-01-01

    To explore factors influencing compliance with campus tobacco policies and strategies to increase compliance. Sixty tobacco smokers (April 2012). A 22-item intercept-interview with closed- and open-ended questions was conducted with smokers in adjacent compliant and noncompliant areas at 1 university with a 100% tobacco ban. Data were analyzed using descriptive statistics and content analysis. Most reported that the smoking policy was not enforced. Noncompliant smokers had less knowledge of locations where tobacco use was permitted and were more likely to identify their smoking location as compliant and had knowingly violated the policy. Choice of location to smoke was related to convenience and a desire to follow the policy. Smokers recommended consequences for noncompliance and structures that accommodated smoking to increase adherence to the tobacco ban. Additional education, environmental, and contingency strategies are needed to increase compliance with the policy banning tobacco use on this campus.

  2. Cable compliance

    NASA Technical Reports Server (NTRS)

    Kerley, J.; Eklund, W.; Burkhardt, R.; Rossoni, P.

    1992-01-01

    The object of the investigation was to solve mechanical problems using cable-in-bending and cable-in-torsion. These problems included robotic contacts, targets, and controls using cable compliance. Studies continued in the use of cable compliance for the handicapped and the elderly. These included work stations, walkers, prosthetic knee joints, elbow joints, and wrist joints. More than half of these objects were met, and models were made and studies completed on most of the others. It was concluded that the many different and versatile solutions obtained only opened the door to many future challenges.

  3. Research Gaps in Wilderness Medicine.

    PubMed

    Tritz, Daniel; Dormire, Kody; Brachtenbach, Travis; Gordon, Joshua; Sanders, Donald; Gearheart, David; Crawford, Julia; Vassar, Matt

    2018-05-18

    Wilderness medicine involves the treatment of individuals in remote, austere environments. Given the high potential for injuries as well as the unique treatment modalities required in wilderness medicine, evidence-based clinical practice guidelines are necessary to provide optimal care. In this study, we identify evidence gaps from low-quality recommendations in wilderness medicine clinical practice guidelines and identify new/ongoing research addressing them. We included relevant clinical practice guidelines from the Wilderness Medical Society and obtained all 1C or 2C level recommendations. Patient/Problem/Population, intervention, comparison, outcome (PICO) questions were created to address each recommendation. Using 24 search strings, we extracted titles, clinical trial registry number, and recruitment status for 8899 articles. We categorized the articles by trial design to infer the effect they may have on future recommendations. Twelve clinical practice guidelines met inclusion criteria. From these we located 275 low-quality recommendations and used them to create 275 PICO questions. Thirty-three articles were relevant to the PICO questions. Heat-related illness had the highest number of relevant articles (n=9), but acute pain and altitude sickness had the most randomized clinical trials (n=6). Overall, few studies were being conducted to address research gaps in wilderness medicine. Heat-related illness had the most new or ongoing research, whereas no studies were being conducted to address gaps in eye injuries, basic wound management, or spine immobilization. Animals, cadavers, and mannequin research are useful in cases in which human evidence is difficult to obtain. Establishing research priorities is recommended for addressing research gaps identified by guideline panels. Copyright © 2018 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  4. Reducing Excellence Gaps: A Research-Based Model

    ERIC Educational Resources Information Center

    Plucker, Jonathan A.; Peters, Scott J.; Schmalensee, Stephanie

    2017-01-01

    As the awareness of the existence and negative effects of excellence gaps has grown among educators and policy makers, so too has a desire for research-supported interventions to reduce these gaps. A recent review of research related to promoting equitable outcomes for all gifted students identified six specific strategies for reducing excellence…

  5. Auditory training and challenges associated with participation and compliance.

    PubMed

    Sweetow, Robert W; Sabes, Jennifer Henderson

    2010-10-01

    When individuals have hearing loss, physiological changes in their brain interact with relearning of sound patterns. Some individuals utilize compensatory strategies that may result in successful hearing aid use. Others, however, are not so fortunate. Modern hearing aids can provide audibility but may not rectify spectral and temporal resolution, susceptibility to noise interference, or degradation of cognitive skills, such as declining auditory memory and slower speed of processing associated with aging. Frequently, these deficits are not identified during a typical "hearing aid evaluation." Aural rehabilitation has long been advocated to enhance communication but has not been considered time or cost-effective. Home-based, interactive adaptive computer therapy programs are available that are designed to engage the adult hearing-impaired listener in the hearing aid fitting process, provide listening strategies, build confidence, and address cognitive changes. Despite the availability of these programs, many patients and professionals are reluctant to engage in and complete therapy. The purposes of this article are to discuss the need for identifying auditory and nonauditory factors that may adversely affect the overall audiological rehabilitation process, to discuss important features that should be incorporated into training, and to examine reasons for the lack of compliance with therapeutic options. Possible solutions to maximizing compliance are explored. Only a small portion of audiologists (fewer than 10%) offer auditory training to patients with hearing impairment, even though auditory training appears to lower the rate of hearing aid returns for credit. Patients to whom auditory training programs are recommended often do not complete the training, however. Compliance for a cohort of home-based auditory therapy trainees was less than 30%. Activities to increase patient compliance to auditory training protocols are proposed. American Academy of Audiology.

  6. The SAT Gender Gap: Identifying the Causes.

    ERIC Educational Resources Information Center

    Rosser, Phyllis

    Questions on the Scholastic Aptitude Test (SAT) with the largest score differences between women and men of all racial and ethnic groups were identified. Patterns of difficulty that would explain the SAT's continuing underprediction of female first-year college performance were studied. An item analysis of one form of the June 1986 SAT for 1,112…

  7. Using health technology assessment to identify gaps in evidence and inform study design for comparative effectiveness research.

    PubMed

    Tunis, Sean R; Turkelson, Charles

    2012-12-01

    Health technology assessment (HTA) is primarily used as a tool to ensure that clinical and policy decisions are made with the benefit of a systematic analysis of all completed research. This article describes the progress and potential for HTA reports to improve the quality and relevance of future research and to better serve the information needs of patients, clinicians, payers, and other decision makers. We conducted a review of the current published literature and working papers describing past, ongoing, and future initiatives that rely on HTA reports to identify gaps in evidence and improve the design of future research. Although still in a developmental stage, significant progress is under way to improve methods for using HTA reports for the systematic identification of research gaps, prioritization of future research, and improvement of study designs. Several well-defined frameworks have been developed to assist those who produce HTA to become more effective in these additional domains of work. A recurring element of this work is the importance of meaningfully involving stakeholders in the process of defining future research needs and designing studies to address them. Patients, clinicians, and payers are important audiences for completed research and are now recognized as serving an important role in determining what future research is needed. There are substantial opportunities to improve the quality, relevance, and efficiency of clinical research. Recent efforts are beginning to demonstrate the potential to build on the work invested in developing HTA reports to provide a roadmap toward these objectives.

  8. Patient Compliance During Contact Lens Wear: Perceptions, Awareness, and Behavior

    PubMed Central

    Bui, Thai H.; Cavanagh, H. Dwight; Robertson, Danielle M.

    2011-01-01

    Objectives Patient noncompliance with recommended hygienic practices in contact lens wear is often considered a significant risk factor for microbial keratitis and adverse contact lens–related events. Despite advancements in lens materials and care solutions, noncompliant behavior continues to hinder efforts to maximize contact lens safety. The objective of this pilot study was to assess the relationship between perceived and actual compliance with awareness of risk and behavior. Methods One hundred sixty-two established contact lens wearers were sequentially evaluated after their routine contact lens examination at the Optometry Clinic at the University of Texas Southwestern Medical Center at Dallas, TX. Each patient was questioned by a single trained interviewer regarding his or her lens care practices and knowledge of risk factors associated with lens wear. Results Eighty-six percent of patients believed they were compliant with lens wear and care practices; 14% identified themselves as noncompliant. Using a scoring model, 32% demonstrated good compliance, 44% exhibited average compliance, and 24% were noncompliant; age was a significant factor (P = 0.020). Only 34% of patients who perceived themselves as compliant exhibited a good level of compliance (P<0.001). Eighty percent of patients reported an awareness of risk factors, but awareness did not influence negative behavior. Replacing the lens case was the only behavior associated with a positive history for having experienced a prior contact lens–related complication (P = 0.002). Conclusions Perceived compliance is not an indicator for appropriate patient behavior. A large proportion of patients remain noncompliant despite awareness of risk. Education alone is not a sufficient strategy to improve behavior; newer approaches aimed at improving compliance with lens care practices are urgently needed. PMID:20935569

  9. Satisfaction, compliance and communication.

    PubMed

    Ley, P

    1982-11-01

    The literature on communication, compliance, and patient satisfaction is selectively reviewed. As in earlier reviews, it is concluded that dissatisfaction with communication remains widespread, as does lack of compliance with medical advice. Related factors include poor transmission of information from patient to doctor, low understandability of communications addressed to the patient, and low levels of recall of information by patients. There does not appear to be any evidence that provision of additional information leads to adverse reactions by patients. Theoretical approaches to communication and compliance are described, and it is concluded that these should be used to direct future research.

  10. [Reflections about non compliance].

    PubMed

    Consoli, S G

    2012-01-01

    Throughout the follow up of a patient suffering from a chronic cutaneous disease, non compliance is rarely avoidable. It is provoked by numerous factors, which have to be looked for in the patient and the doctor, as well, and in the external reality, as in the internal, psychic, reality, both of the patient and the doctor. Being aware of these factors is fundamental for resolving the non compliance conflict. Thus, non compliance can become a chance to seize for avoiding patients' wandering and building a more dynamic, authentic and stronger doctor-patient relationship. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  11. 78 FR 4323 - Compliance and Enforcement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ... DEPARTMENT OF THE INTERIOR National Indian Gaming Commission 25 CFR Part 573 Compliance and... enforcement regulation to include a graduated pre-enforcement process for voluntary compliance. That rule... part 573 (Compliance and Enforcement) to include a graduated pre- enforcement process through which a...

  12. College and University Compliance With a Required Meningococcal Vaccination Law

    PubMed Central

    Castel, Amanda D.; Reed, Greg; Davenport, Marsha G.; Harrison, Lee H.; Blythe, David

    2015-01-01

    Objective Maryland became the first state to pass a vaccination law requiring college and university students living on campus to obtain a meningococcal vaccination or to sign a waiver refusing vaccination because college students are at increased risk for disease. The authors sought to identify how Maryland colleges addressed the law and determine whether schools were in full compliance. Participants The authors surveyed 32 college/university administrators via a self-administered questionnaire. Methods The authors calculated vaccination and waiver rates and assessed compliance with the law overall and with specific law components. Results Among 28 participating schools, annual vaccination rates and waiver rates among students during 2000–2004 ranged from 66%–76% and 12%–17%, respectively. Two (7%) schools were compliant with all components of the law. Conclusions Mandatory vaccination laws do not ensure compliance at the college and university level. Mandatory reporting, increased education, and collaboration between colleges and universities and public health agencies are needed. PMID:17967757

  13. Gap analysis of cultural and religious needs of hospitalized patients.

    PubMed

    Davidson, Judy E; Boyer, Merri Lynn; Casey, Debra; Matzel, Stephen Chavez; Walden, Chaplain David

    2008-01-01

    Identify patient and family needs specifically related to an in-hospital birth or death. This study aimed to perform a gap analysis between identified needs and current hospital practice, services, and resources. With the IRB approval, and purposive sampling using the demographics of a community hospital plus subgroups from problematic cases. Twenty-two semistructured interviews were audiotaped, and 6 lectures and 2 panel discussions were videotaped. Transcriptions were distributed to the research team and manually coded for gaps between current practices versus stated needs. Group process was used to form consensus regarding findings. The following subgroups were targeted: Muslim, Baha'i, Catholic, Protestant, Jewish, Buddhist, Mormon, Jehovah's Witness, Latino, Filipino, Chinese, African American. Gaps in available resources, such as prayer books, rugs, and compasses, were identified. Knowledge gaps included many issues such as the Muslim preference for decreasing sedatives at end of life to be able to recite the sacred prayer while dying. Practice issues such as respecting plain-clothed clergy, the impact of "rule-orientation" on family needs, and the universal need to call clergy early were identified.

  14. Handwashing compliance: what works?

    PubMed

    Serkey, J M; Hall, G S

    2001-04-01

    Health care personnel--particularly physicians--do a poor job of complying with national handwashing guidelines, yet handwashing is the cornerstone of infection control. New products designed to increase compliance are available, such as automated handwashing machines, but their clinical benefits have not been fully studied. The best solution for now may be to continue awareness campaigns and education programs, ensure access to sinks and appropriate antiseptic products, and promote the use of alcohol disinfectants when handwashing is not possible. Antiseptic products are now preferred over handwashing with plain soap, which does not reliably prevent transmission of bacteria. Because 100% compliance may not be realistic, interventions that improve compliance, such as the use of alcohol sanitizing products when handwashing is not possible, may be the best solution. A number of barriers deter compliance, including lack of access to handwashing stations and lack of time. Gloves are not a substitute for handwashing because they are not fully protective.

  15. 28 CFR 42.730 - Compliance reviews.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Compliance reviews. 42.730 Section 42.730 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... of the Age Discrimination Act of 1975 Compliance Procedures § 42.730 Compliance reviews. The...

  16. 40 CFR 52.1175 - Compliance schedules.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Compliance schedules. 52.1175 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Michigan § 52.1175 Compliance schedules. (a... Rule 336.49 of the Michigan Air Pollution Control Commission provides for individual compliance...

  17. Rapid anti-transglutaminase assay and patient interview for monitoring dietary compliance in celiac disease.

    PubMed

    Zanchi, Chiara; Ventura, Alessandro; Martelossi, Stefano; Di Leo, Grazia; Di Toro, Nicola; Not, Tarcisio

    2013-06-01

    The anti-transglutaminase antibodies (anti-tTG) play an important role in monitoring the celiacs' gluten-free diet (GFD). The authors propose to use the rapid IgA anti-tTG assay based on a whole blood drop to evaluate the compliance to GFD at the clinical ambulatory setting. The rapid test results were compared with those of the conventional ELISA assay and with dietary compliance reported by patients' interview. The authors showed that anti-tTG rapid test is reliable and easy to perform in the ambulatory setting to evaluate dietary compliance. Moreover, they proved that celiacs' interview is more sensitive than serology in identifying patients who transgress.

  18. 17 CFR 38.155 - Compliance staff and resources.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Compliance staff and resources... DESIGNATED CONTRACT MARKETS Compliance With Rules § 38.155 Compliance staff and resources. (a) Sufficient compliance staff. A designated contract market must establish and maintain sufficient compliance department...

  19. 17 CFR 38.155 - Compliance staff and resources.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 1 2013-04-01 2013-04-01 false Compliance staff and resources... DESIGNATED CONTRACT MARKETS Compliance With Rules § 38.155 Compliance staff and resources. (a) Sufficient compliance staff. A designated contract market must establish and maintain sufficient compliance department...

  20. Clinical trial regulation in Argentina: overview and analysis of regulatory framework, use of existing tools, and researchers' perspectives to identify potential barriers.

    PubMed

    White, Lauren; Ortiz, Zulma; Cuervo, Luis G; Reveiz, Ludovic

    2011-11-01

    To review and analyze the regulatory framework of clinical trial registration, use of existing tools (publicly accessible national/international registration databases), and users' perspectives to identify possible barriers to registration compliance by sponsors and researchers in Argentina. Internationally registered trials recruiting patients in Argentina were found through clincialtrials.gov and the International Clinical Trial Registration Platform (ICTRP) and compared with publically available clinical trials registered through the National Administration of Drugs, Foods, and Medical Devices (ANMAT). A questionnaire addressing hypothesized attitudinal, knowledge-related, idiomatic, technical, economic, and regulatory barriers that could discourage or impede registration of clinical trials was developed, and semi-structured, in-depth interviews were conducted with a purposively selected sample of researchers (investigators, sponsors, and monitors) in Argentina. A response rate of 74.3% (n = 29) was achieved, and 27 interviews were ultimately used for analysis. Results suggested that the high proportion of foreign-sponsored or multinational trials (64.8% of all protocols approved by ANMAT from 1994-2006) may contribute to a communication gap between locally based investigators and foreign-based administrative officials. A lack of knowledge about available international registration tools and limited awareness of the importance of registration were also identified as limiting factors for local investigators and sponsors. To increase compliance and promote clinical trial registration in Argentina, national health authorities, sponsors, and local investigators could take the following steps: implement a grassroots educational campaign to improve clinical trial regulation, support local investigator-sponsor-initiated clinical trials, and/or encourage local and regional scientific journal compliance with standards from the International Committee of Medical Journal

  1. Gap analysis: synergies and opportunities for effective nursing leadership.

    PubMed

    Davis-Ajami, Mary Lynn; Costa, Linda; Kulik, Susan

    2014-01-01

    Gap analysis encompasses a comprehensive process to identify, understand, address, and bridge gaps in service delivery and nursing practice. onducting gap analysis provides structure to information gathering and the process of finding sustainable solutions to important deficiencies. Nursing leaders need to recognize, measure, monitor, and execute on feasible actionable solutions to help organizations make adjustments to address gaps between what is desired and the actual real-world conditions contributing to the quality chasm in health care. Gap analysis represents a functional and comprehensive tool to address organizational deficiencies. Using gap analysis proactively helps organizations map out and sustain corrective efforts to close the quality chasm. Gaining facility in gap analysis should help the nursing profession's contribution to narrowing the quality chasm.

  2. 24 CFR 964.310 - Audit/compliance requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... or Field Office management review findings. In addition, the HA must be in compliance with civil rights laws and equal opportunity requirements. A HA will be considered to be in compliance if: (a) As a... civil rights laws unless the HA is operating in compliance with a HUD-approved compliance agreement...

  3. Incorporating shrub and snag specific LiDAR data into GAP wildlife models

    Treesearch

    Teresa J Lorenz; Kerri T Vierling; Jody Vogeler; Jeffrey Lonneker; Jocelyn Aycrigg

    2015-01-01

    The U.S. Geological Survey’s Gap Analysis Program (hereafter, GAP) is a nationally based program that uses land cover, vertebrate distributions, and land ownership to identify locations where gaps in conservation coverage exist, and GAP products are commonly used by government agencies, nongovernmental organizations, and private citizens. The GAP land-cover...

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

    PubMed

    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.

  5. 3 CFR - Regulatory Compliance

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Regulatory Compliance Presidential Documents Other Presidential Documents Memorandum of January 18, 2011 Regulatory Compliance Memorandum for the Heads of Executive Departments and Agencies My Administration is committed to enhancing effectiveness and efficiency in Government. Pursuant to the...

  6. 36 CFR 1211.605 - Compliance information.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Compliance information. 1211... FINANCIAL ASSISTANCE Procedures § 1211.605 Compliance information. (a) Cooperation and assistance. The..., complete, and accurate compliance reports at such times, and in such form and containing such information...

  7. 49 CFR 27.121 - Compliance information.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false Compliance information. 27.121 Section 27.121... OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Enforcement § 27.121 Compliance information. (a... compliance reports at such times, and in such form, and containing such information as the responsible...

  8. 36 CFR 9.85 - Environmental compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Environmental compliance. 9... MINERALS MANAGEMENT Alaska Mineral Resource Assessment Program § 9.85 Environmental compliance. Each AMRAP... sufficient information to the NPS to ensure appropriate compliance with the National Environmental Policy Act...

  9. 36 CFR 406.170 - Compliance procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Compliance procedures. 406... BATTLE MONUMENTS COMMISSION § 406.170 Compliance procedures. (a) Except as provided in paragraph (b) of... Architectural and Transportation Barriers Compliance Board upon receipt of any complaint alleging that a...

  10. 36 CFR 909.170 - Compliance procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Compliance procedures. 909... PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION § 909.170 Compliance procedures. (a) Except as provided in... Barriers Compliance Board upon receipt of any complaint alleging that a building or facility that is...

  11. 36 CFR 812.170 - Compliance procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Compliance procedures. 812... COUNCIL ON HISTORIC PRESERVATION § 812.170 Compliance procedures. (a) Except as provided in paragraph (b...) The agency shall notify the Architectural and Transportation Barriers Compliance Board upon receipt of...

  12. 36 CFR 9.85 - Environmental compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Environmental compliance. 9... MINERALS MANAGEMENT Alaska Mineral Resource Assessment Program § 9.85 Environmental compliance. Each AMRAP... sufficient information to the NPS to ensure appropriate compliance with the National Environmental Policy Act...

  13. 40 CFR 425.05 - Compliance dates.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Compliance dates. 425.05 Section 425... STANDARDS LEATHER TANNING AND FINISHING POINT SOURCE CATEGORY General Provisions § 425.05 Compliance dates. The compliance date for new source performance standards (NSPS) and pretreatment standards for new...

  14. 45 CFR 1110.6 - Compliance information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance information. 1110.6 Section 1110.6... HUMANITIES GENERAL NONDISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS § 1110.6 Compliance information. (a... the cooperation of recipients in obtaining compliance with this part and shall provide assistance and...

  15. 34 CFR 1200.170 - Compliance procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 4 2011-07-01 2011-07-01 false Compliance procedures. 1200.170 Section 1200.170... THE NATIONAL COUNCIL ON DISABILITY § 1200.170 Compliance procedures. (a) Except as provided in... agency shall notify the Architectural and Transportation Barriers Compliance Board upon receipt of any...

  16. 49 CFR 807.170 - Compliance procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Compliance procedures. 807.170 Section 807.170... TRANSPORTATION SAFETY BOARD § 807.170 Compliance procedures. (a) Except as provided in paragraph (b) of this... the Architectural and Transportation Barriers Compliance Board upon receipt of any complaint alleging...

  17. 45 CFR 1175.170 - Compliance procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance procedures. 1175.170 Section 1175.170... PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE HUMANITIES § 1175.170 Compliance...) The agency shall notify the Architectural and Transportation Barriers Compliance Board upon receipt of...

  18. Regulatory Compliance in Multi-Tier Supplier Networks

    NASA Technical Reports Server (NTRS)

    Goossen, Emray R.; Buster, Duke A.

    2014-01-01

    Over the years, avionics systems have increased in complexity to the point where 1st tier suppliers to an aircraft OEM find it financially beneficial to outsource designs of subsystems to 2nd tier and at times to 3rd tier suppliers. Combined with challenging schedule and budgetary pressures, the environment in which safety-critical systems are being developed introduces new hurdles for regulatory agencies and industry. This new environment of both complex systems and tiered development has raised concerns in the ability of the designers to ensure safety considerations are fully addressed throughout the tier levels. This has also raised questions about the sufficiency of current regulatory guidance to ensure: proper flow down of safety awareness, avionics application understanding at the lower tiers, OEM and 1st tier oversight practices, and capabilities of lower tier suppliers. Therefore, NASA established a research project to address Regulatory Compliance in a Multi-tier Supplier Network. This research was divided into three major study efforts: 1. Describe Modern Multi-tier Avionics Development 2. Identify Current Issues in Achieving Safety and Regulatory Compliance 3. Short-term/Long-term Recommendations Toward Higher Assurance Confidence This report presents our findings of the risks, weaknesses, and our recommendations. It also includes a collection of industry-identified risks, an assessment of guideline weaknesses related to multi-tier development of complex avionics systems, and a postulation of potential modifications to guidelines to close the identified risks and weaknesses.

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

    PubMed

    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.

  20. Tensile-strain effect of inducing the indirect-to-direct band-gap transition and reducing the band-gap energy of Ge

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Inaoka, Takeshi, E-mail: inaoka@phys.u-ryukyu.ac.jp; Furukawa, Takuro; Toma, Ryo

    By means of a hybrid density-functional method, we investigate the tensile-strain effect of inducing the indirect-to-direct band-gap transition and reducing the band-gap energy of Ge. We consider [001], [111], and [110] uniaxial tensility and (001), (111), and (110) biaxial tensility. Under the condition of no normal stress, we determine both normal compression and internal strain, namely, relative displacement of two atoms in the primitive unit cell, by minimizing the total energy. We identify those strain types which can induce the band-gap transition, and evaluate the critical strain coefficient where the gap transition occurs. Either normal compression or internal strain operatesmore » unfavorably to induce the gap transition, which raises the critical strain coefficient or even blocks the transition. We also examine how each type of tensile strain decreases the band-gap energy, depending on its orientation. Our analysis clearly shows that synergistic operation of strain orientation and band anisotropy has a great influence on the gap transition and the gap energy.« less

  1. 43 CFR 34.10 - Compliance reviews.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Compliance reviews. 34.10 Section 34.10... CONSTRUCTION AND OPERATION OF THE ALASKA NATURAL GAS TRANSPORTATION SYSTEM § 34.10 Compliance reviews. (a) Periodic compliance procedures. (1) The Federal Inspector will review the practices of recipients...

  2. 46 CFR 107.205 - Alternate compliance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Alternate compliance. 107.205 Section 107.205 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.205 Alternate compliance. (a) In place of compliance with other...

  3. 46 CFR 107.205 - Alternate compliance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Alternate compliance. 107.205 Section 107.205 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.205 Alternate compliance. (a) In place of compliance with other...

  4. 46 CFR 107.205 - Alternate compliance.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Alternate compliance. 107.205 Section 107.205 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.205 Alternate compliance. (a) In place of compliance with other...

  5. 46 CFR 107.205 - Alternate compliance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Alternate compliance. 107.205 Section 107.205 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.205 Alternate compliance. (a) In place of compliance with other...

  6. 46 CFR 107.205 - Alternate compliance.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Alternate compliance. 107.205 Section 107.205 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Inspection and Certification § 107.205 Alternate compliance. (a) In place of compliance with other...

  7. 45 CFR 1203.6 - Compliance information.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Compliance information. 1203.6 Section 1203.6... OF 1964 § 1203.6 Compliance information. (a) Cooperation and assistance. ACTION, to the fullest... compliance reports at the times, and in the form and containing the information ACTION may determine...

  8. 45 CFR 1203.6 - Compliance information.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Compliance information. 1203.6 Section 1203.6... OF 1964 § 1203.6 Compliance information. (a) Cooperation and assistance. ACTION, to the fullest... compliance reports at the times, and in the form and containing the information ACTION may determine...

  9. 45 CFR 1203.6 - Compliance information.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Compliance information. 1203.6 Section 1203.6... OF 1964 § 1203.6 Compliance information. (a) Cooperation and assistance. ACTION, to the fullest... compliance reports at the times, and in the form and containing the information ACTION may determine...

  10. 28 CFR 42.106 - Compliance information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Compliance information. 42.106 Section 42... Civil Rights Act of 1964 1 § 42.106 Compliance information. (a) Cooperation and assistance. Each... compliance reports at such times, and in such form and containing such information, as the responsible...

  11. 18 CFR 1307.8 - Compliance information.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Compliance information... NONDISCRIMINATION WITH RESPECT TO HANDICAP § 1307.8 Compliance information. (a) Cooperation and assistance. TVA..., complete and accurate compliance reports at such times, and in such form and containing such information...

  12. 30 CFR 57.5061 - Compliance determinations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Compliance determinations. 57.5061 Section 57....5061 Compliance determinations. (a) MSHA will use a single sample collected and analyzed by the... for the measurement of DPM. (c) The Secretary will use full-shift personal sampling for compliance...

  13. 38 CFR 18.6 - Compliance information.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Compliance information... THE CIVIL RIGHTS ACT OF 1964 General § 18.6 Compliance information. (a) Cooperation and assistance... compliance reports at such times, and in such form and containing such information, as the responsible agency...

  14. 22 CFR 209.6 - Compliance information.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  15. 45 CFR 85.61 - Compliance procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Compliance procedures. 85.61 Section 85.61 Public... SERVICES § 85.61 Compliance procedures. (a) Except as provided in paragraph (c) of this section, this... Federal government entity. (f) OCR shall notify the Architectural and Transportation Barriers Compliance...

  16. 45 CFR 1153.170 - Compliance procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance procedures. 1153.170 Section 1153.170... PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS § 1153.170 Compliance procedures... and Transportation Barriers Compliance Board upon receipt of any complaint alleging that a building or...

  17. 29 CFR 100.570 - Compliance procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Compliance procedures. 100.570 Section 100.570 Labor... § 100.570 Compliance procedures. (a) Except as provided in paragraph (b) of this section, this section... the Architectural and Transportation Barriers Compliance Board upon receipt of any complaint alleging...

  18. 42 CFR 3.308 - Compliance reviews.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Compliance reviews. 3.308 Section 3.308 Public... ORGANIZATIONS AND PATIENT SAFETY WORK PRODUCT Enforcement Program § 3.308 Compliance reviews. The Secretary may conduct compliance reviews to determine whether a respondent is complying with the applicable...

  19. Use of acceptable knowledge to demonstrate TRAMPAC compliance

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Whitworth, J.; Becker, B.; Guerin, D.

    2004-01-01

    used to fully demonstrate TRAMPAC compliance, it may be used to identify problem areas for shippability of different waste streams. An example is the case of Pu-238-contaminated waste from the Savannah River Site that had a low probability of meeting decay heat limits and aspiration times due to several factors including large numbers of confinement layers. This paper will outline 17 TRAMPAC compliance criteria assessed and the types of information used to show compliance with all criteria other than dose rate and container weight, which are normally easily measured at load preparation.« less

  20. Behavioural treatment of non-compliance in adolescents with newly acquired spinal cord injuries.

    PubMed

    Gorski, Jo Anne; Slifer, Keith J; Townsend, Vanessa; Kelly-Suttka, Jennifer; Amari, Adrianna

    2005-01-01

    To demonstrate the efficacy of using differential reinforcement to treat non-compliance in adolescents with spinal cord injury. A case series design was used to examine three adolescents (aged 14-16 years) with tetraplegia who received multi-disciplinary rehabilitation treatment and a behavioural contract programme during an in-patient hospital admission. Assessment included collecting data on each patient's weekly percentage of compliance with all rehabilitation goals, weekly percentage of negative affect observed in therapy sessions and scores on a measure of mobility in physical therapy. Compliance with rehabilitation demands improved from a baseline of 20-65% to 80% or greater after the patients received differential reinforcement for participating in the rehabilitation regimen. Patients exhibited less anger, sadness and frustration during therapy sessions once contracts were started. The adolescents demonstrated greater compliance after the implementation of a behavioural contract. Future studies should identify the specific variables that affect psychological adjustment and predict 'readiness' to participate in rehabilitation.

  1. Force reflection with compliance control

    NASA Technical Reports Server (NTRS)

    Kim, Won S. (Inventor)

    1993-01-01

    Two types of systems for force-reflecting control, which enables high force-reflection gain, are presented: position-error-based force reflection and low-pass-filtered force reflection. Both of the systems are combined with shared compliance control. In the position-error-based class, the position error between the commanded and the actual position of a compliantly controlled robot is used to provide force reflection. In the low-pass-filtered force reflection class, the low-pass-filtered output of the compliance control is used to provide force reflection. The increase in force reflection gain can be more than 10-fold as compared to a conventional high-bandwidth pure force reflection system, when high compliance values are used for the compliance control.

  2. [Kidney patients: aspects related to compliance with renal treatment].

    PubMed

    Caraballo Nazario, G L; Lebrón de avilés, C; Dávila Torres, R R; Burgos Calderón, R

    2001-12-01

    The Objective of this study was identify the aspects related with the adherence of medical treatment recommended to the patients that received hemodialysis in the tertiary public hospital. A non experimental transectional correlation design was utilized in this study. Fifty-three patients constituted the population study. A structure interview was utilized to gathered the data. Descriptive statistics and Chi-square tests were utilized to analysis. The response rate was 91.0%. The 75.0% of patients not compliance with the medical treatment. Significant association between compliance variable and educational level was encountered (p < or = 0.05). This study provides important findings to will develops educative intervention in the Renal Unit, directed to improve the adherence of the patient with medical treatment.

  3. 14 CFR 1252.400 - Compliance reviews.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Compliance reviews. 1252.400 Section 1252..., and Enforcement Procedures § 1252.400 Compliance reviews. (a) NASA may conduct compliance reviews and pre-award reviews of recipients or use other similar procedures that will permit it to investigate and...

  4. 43 CFR 17.330 - Compliance reviews.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Compliance reviews. 17.330 Section 17.330..., Conciliation, and Enforcement Procedures § 17.330 Compliance reviews. (a) DOI may conduct compliance reviews and pre-award reviews of recipients or use other similar procedures that will permit it to investigate...

  5. 40 CFR 63.1351 - Compliance dates.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... or startup for sources that commenced construction after March 24, 1998. (b) The compliance date for... before or on December 20, 2006, or (2) Startup for sources that commenced construction after December 20... compliance date for new sources is February 12, 2013, or startup, whichever is later. (e) The compliance date...

  6. 40 CFR 63.1351 - Compliance dates.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... or startup for sources that commenced construction after March 24, 1998. (b) The compliance date for... before or on December 20, 2006, or (2) Startup for sources that commenced construction after December 20... compliance date for new sources is February 12, 2013, or startup, whichever is later. (e) The compliance date...

  7. 40 CFR 68.58 - Compliance audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Compliance audits. 68.58 Section 68.58... ACCIDENT PREVENTION PROVISIONS Program 2 Prevention Program § 68.58 Compliance audits. (a) The owner or... are being followed. (b) The compliance audit shall be conducted by at least one person knowledgeable...

  8. 40 CFR 68.79 - Compliance audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Compliance audits. 68.79 Section 68.79... ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.79 Compliance audits. (a) The owner or... are being followed. (b) The compliance audit shall be conducted by at least one person knowledgeable...

  9. 29 CFR 30.9 - Compliance reviews.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Compliance reviews. 30.9 Section 30.9 Labor Office of the Secretary of Labor EQUAL EMPLOYMENT OPPORTUNITY IN APPRENTICESHIP AND TRAINING § 30.9 Compliance reviews. (a) Conduct of compliance reviews. The Department will regularly conduct systematic reviews of apprenticeship...

  10. 29 CFR 30.9 - Compliance reviews.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 1 2011-07-01 2011-07-01 false Compliance reviews. 30.9 Section 30.9 Labor Office of the Secretary of Labor EQUAL EMPLOYMENT OPPORTUNITY IN APPRENTICESHIP AND TRAINING § 30.9 Compliance reviews. (a) Conduct of compliance reviews. The Department will regularly conduct systematic reviews of apprenticeship...

  11. 24 CFR 107.40 - Compliance meeting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  12. 45 CFR 611.6 - Compliance information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance information. 611.6 Section 611.6 Public... CIVIL RIGHTS ACT OF 1964 § 611.6 Compliance information. (a) Cooperation and assistance. The responsible... compliance with this part and shall provide assistance and guidance to recipients to help them comply...

  13. 45 CFR 90.44 - Compliance reviews.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Compliance reviews. 90.44 Section 90.44 Public... Enforcement Procedures § 90.44 Compliance reviews. (a) Each agency shall provide in its regulations that it may conduct compliance reviews, pre-award reviews, and other similar procedures which permit the...

  14. 45 CFR 1156.19 - Compliance procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance procedure. 1156.19 Section 1156.19..., and Enforcement Procedures § 1156.19 Compliance procedure. (a) The Endowment may enforce the Act and... compliance cannot be obtained. (2) Thirty days have elapsed after the Chairperson has sent a written report...

  15. 45 CFR 617.12 - Compliance procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance procedure. 617.12 Section 617.12 Public....12 Compliance procedure. (a) NSF may enforce this part by either termination of a recipient's... recipient of its failure to comply with this part and has determined that voluntary compliance cannot be...

  16. 45 CFR 1181.170 - Compliance procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance procedures. 1181.170 Section 1181.170... Compliance procedures. (a) Except as provided in paragraph (b) of this section, this section applies to all... Transportation Barriers Compliance Board upon receipt of any complaint alleging that a building or facility that...

  17. 45 CFR 707.12 - Compliance procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance procedures. 707.12 Section 707.12.... COMMISSION ON CIVIL RIGHTS § 707.12 Compliance procedures. (a) Except as provided in paragraph (b) of this...) The Agency shall notify the Architectural and Transportation Barriers Compliance Board upon receipt of...

  18. 34 CFR 105.41 - Compliance procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Compliance procedures. 105.41 Section 105.41 Education... DEPARTMENT OF EDUCATION § 105.41 Compliance procedures. (a) Except as provided in paragraph (b) of this... Transportation Barriers Compliance Board upon receipt of any complaint alleging that a building or facility that...

  19. Handwashing compliance.

    PubMed

    Antoniak, Jeannie

    2004-09-01

    Undeniably, handwashing remains the single most effective and cost-efficient method for preventing and reducing the transmission of nosocomial infections. Yet the rates and outbreaks of nosocomial infections in Canadian and international healthcare institutions continue to increase. Shaikh Khalifa Medical Center developed and implemented a multidisciplinary approach to address the challenges of handwashing compliance among nurses and healthcare workers in its workplace setting. Supported by evidence-based research, the approach consisted of three components: collaboration, implementation and evaluation. The use of the alcohol-based hand rub sanitizer or "solution" was integral to the multidisciplinary approach. Ongoing education, communication and a committed leadership were essential to promote and sustain handwashing compliance.

  20. The new hospice compliance plan: defining and addressing risk areas. Part 3.

    PubMed

    Jones, D H; Woods, K

    2000-07-01

    The recently released OIG guidelines to ensure compliance with federal and state statutes, rules, and regulations, and private-payor health care program requirements provide a blueprint for developing such programs. This is the last of three installments that focus specifically on the 28 risk areas identified in the guidance and offer strategies for incorporating them in a hospice compliance program. The authors have organized the 28 risk areas under 9 topic domains to simplify the task of tackling the guidance. This article covers the areas of nursing home care, marketing, and Conditions of Participation.

  1. Environmental Compliance Guide

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    1981-02-01

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

  2. Medical Simulation as a Vital Adjunct to Identifying Clinical Life-Threatening Gaps in Austere Environments.

    PubMed

    Chima, Adaora M; Koka, Rahul; Lee, Benjamin; Tran, Tina; Ogbuagu, Onyebuchi U; Nelson-Williams, Howard; Rosen, Michael; Koroma, Michael; Sampson, John B

    2018-04-01

    substantial risks to patient care and provides evidence to support the feasibility and value of in-situ simulation-based performance assessment for identifying critical gaps in safe anesthesia care in the low-resource settings. Further investigations may validate the impact and sustainability of simulation based training on skills transfer and retention among anesthesia providers low resource environments. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

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

    PubMed Central

    Pounder, Neill M; Jones, John T; Tanis, Kevin J

    2016-01-01

    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. PMID:27942237

  4. Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birth.

    PubMed

    Shimoni, Zvi; Kama, Naama; Mamet, Yaakov; Glick, Joseph; Dusseldorp, Natan; Froom, Paul

    2009-11-01

    Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birth. 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. 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. 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. 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). Surgical nurses can ensure universal compliance for antibiotic prophylaxis in women after caesarean birth, leading to a reduction in wound infections.

  5. Compliance with medical regimens during adolescence.

    PubMed

    Litt, I F; Cuskey, W R

    1980-02-01

    In summary, compliance behavior among adolescents is complex and imcompletely understood. Although the study of compliance is important for understanding the adolescent's stage of psychological development, relationships with authority figures, and the beginning of the youngster's career as a consumer of health care, its ultimate importance lies in the prospect of improving the likelihood that medication will be utilized appropriately. The first step in the process involves systematic monitoring of compliance rather than doing so only when noncompliance is clinically suspected. When compliance is found to be problematic for an adolescent, resorting to "scare" techniques or re-education is rarely effective. A more positive outcome may be achieved by determining the circumstances under which the youngster was successful in complying and attempting to tailor-make the regimen accordingly. Barriers to compliance, such as the presence of side effects, previous negative experience with the medicine, and lack of conviction about the diagnosis of appropriateness of therapy, should always be explored. Other potential intervention strategies for improving compliance have been discussed. In the final analysis, however, as Jonson has noted, all strategies aimed at improving compliance must provide the patient with insight into his own situation and himself, as well as his capability of doing something other than conforming when he judges it best.

  6. 40 CFR 63.826 - Compliance dates.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 10 2011-07-01 2011-07-01 false Compliance dates. 63.826 Section 63... Emission Standards for the Printing and Publishing Industry § 63.826 Compliance dates. (a) The compliance date for an owner or operator of an existing affected source subject to the provisions of this subpart...

  7. 45 CFR 98.91 - Non-compliance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Non-compliance. 98.91 Section 98.91 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Monitoring, Non-compliance and Complaints § 98.91 Non-compliance. (a) If after reasonable notice to a Lead Agency...

  8. 24 CFR 108.25 - Compliance meeting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  9. 34 CFR 100.6 - Compliance information.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Compliance information. 100.6 Section 100.6 Education... TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 § 100.6 Compliance information. (a) Cooperation and assistance... recipients in obtaining compliance with this part and shall provide assistance and guidance to recipients to...

  10. 10 CFR 851.4 - Compliance order.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Compliance order. 851.4 Section 851.4 Energy DEPARTMENT OF ENERGY WORKER SAFETY AND HEALTH PROGRAM General Provisions § 851.4 Compliance order. (a) The Secretary... effectiveness of a Compliance Order unless the Secretary issues an order to that effect. (d) A copy of the...

  11. 45 CFR 91.46 - Compliance procedure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Compliance procedure. 91.46 Section 91.46 Public..., Conciliation, and Enforcement Procedures § 91.46 Compliance procedure. (a) HHS may enforce the Act and these... compliance cannot be obtained. (2) Thirty days have elapsed after the Secretary has sent a written report of...

  12. WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries.

    PubMed

    Keynejad, Roxanne C; Dua, Tarun; Barbui, Corrado; Thornicroft, Graham

    2018-02-01

    Despite mental, neurological and substance use (MNS) disorders being highly prevalent, there is a worldwide gap between service need and provision. WHO launched its Mental Health Gap Action Programme (mhGAP) in 2008, and the Intervention Guide (mhGAP-IG) in 2010. mhGAP-IG provides evidence-based guidance and tools for assessment and integrated management of priority MNS disorders in low and middle-income countries (LMICs), using clinical decision-making protocols. It targets a non-specialised primary healthcare audience, but has also been used by ministries, non-governmental organisations and academics, for mental health service scale-up in 90 countries. This review aimed to identify evidence to date for mhGAP-IG implementation in LMICs. We searched MEDLINE, Embase, PsycINFO, Web of Knowledge/Web of Science, Scopus, CINAHL, LILACS, SciELO/Web of Science, Cochrane, Pubmed databases and Google Scholar for studies reporting evidence, experience or evaluation of mhGAP-IG in LMICs, in any language. Data were extracted from included papers, but heterogeneity prevented meta-analysis. We conducted a systematic review of evidence to date, of mhGAP-IG implementation and evaluation in LMICs. Thirty-three included studies reported 15 training courses, 9 clinical implementations, 3 country contextualisations, 3 economic models, 2 uses as control interventions and 1 use to develop a rating scale. Our review identified the importance of detailed reports of contextual challenges in the field, alongside detailed protocols, qualitative studies and randomised controlled trials. The mhGAP-IG literature is substantial, relative to other published evaluations of clinical practice guidelines: an important contribution to a neglected field. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Weight Management Belief is the Leading Influential Factor of Weight Monitoring Compliance in Congestive Heart Failure Patients.

    PubMed

    Lu, Min-Xia; Zhang, Yan-Yun; Jiang, Jun-Fang; Ju, Yang; Wu, Qing; Zhao, Xin; Wang, Xiao-Hua

    2016-11-01

    Daily weight monitoring is frequently recommended as a part of heart failure self-management to prevent exacerbations. This study is to identify factors that influence weight monitoring compliance of congestive heart failure patients at baseline and after a 1-year weight management (WM) program. This was a secondary analysis of an investigative study and a randomized controlled study. A general information questionnaire assessed patient demographics and clinical variables such as medicine use and diagnoses, and the weight management scale evaluated their WM abilities. Good and poor compliance based on abnormal weight gain from the European Society of Cardiology (> 2 kg in 3 days) were compared, and hierarchical multiple logistic regression analysis was used to identify factors influencing weight monitoring compliance. A total of 316 patients were enrolled at baseline, and 66 patients were enrolled after the 1-year WM program. Of them, 12.66% and 60.61% had good weight monitoring compliance at baseline and after 1 year of WM, respectively. A high WM-related belief score indicated good weight monitoring compliance at both time points [odds ratio (OR), 1.043, 95% confidence interval (CI), 1.023-1.063, p < 0.001; and OR, 2.054, 95% CI, 1.209-3.487, p < 0.001, respectively). Patients with a high WM-related practice score had good weight monitoring compliance at baseline (OR, 1.046, 95% CI, 1.027-1.065, p < 0.001), and patients who had not monitored abnormal weight had poor weight monitoring compliance after the 1-year WM program (OR, 0.244, 95% CI, 0.006-0.991, p = 0.049). Data from this study suggested that belief related to WM plays an important role in weight monitoring compliance.

  14. Clean Air Markets - Compliance Query Wizard

    EPA Pesticide Factsheets

    The Compliance Query Wizard is part of a suite of Clean Air Markets-related tools that are accessible at http://ampd.epa.gov/ampd/. The Compliance module provides final compliance results. Using the Compliance Query Wizard, the user can find compliance information associated with specific programs, facilities, states or time frames. Quick Reports and Prepackaged Datasets are also available for data that are commonly requested. Final compliance results are available for all years since 1995 for the Acid Rain Program and for the various NOx trading programs EPA has operated since 1999.EPA's Clean Air Markets Division (CAMD) includes several market-based regulatory programs designed to improve air quality and ecosystems. The most well-known of these programs are EPA's Acid Rain Program and the NOx Programs, which reduce emissions of sulfur dioxide (SO2) and nitrogen oxides (NOx)-compounds that adversely affect air quality, the environment, and public health. CAMD also plays an integral role in the development and implementation of the Clean Air Interstate Rule (CAIR).

  15. ROSS Skills, Knowledge, and Abilities Training Evaluation. Gaps and Recommendations

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ala, Maureen; Gruidl, Jeremiah; Buddemeier, Brooke

    2015-09-30

    This document describes the development of the ROSS SKAs, the cross-mapping of the SKAs to the available training, identifies gaps in the SKA and training, and provides recommendations to address those gaps.

  16. Cochrane systematic reviews are useful to map research gaps for decreasing maternal mortality.

    PubMed

    Chapman, Evelina; Reveiz, Ludovic; Chambliss, Amy; Sangalang, Stephanie; Bonfill, Xavier

    2013-01-01

    To use an "evidence-mapping" approach to assess the usefulness of Cochrane reviews in identifying research gaps in the maternal health. The article describes the general mapping, prioritizing, reconciling, and updating approach: (1) identifying gaps in the maternal health research using published systematic reviews and formulating research questions, (2) prioritizing questions using Delphi method, (3) reconciling identified research priorities with the existing literature (i.e., searching of ongoing trials in trials registries), (4) updating the process. A comprehensive search of Cochrane systematic reviews published or updated from January 2006 to March 2011 was performed. We evaluated the "Implications for Research" section to identify gaps in the research. Our search strategy identified 695 references; 178 systematic reviews identifying at least one research gap were used. We formulated 319 research questions, which were classified into 11 different categories based on the direct and indirect causes of maternal mortality: postpartum hemorrhage, abortion, hypertensive disorders, infection/sepsis, caesarean section, diabetes, pregnancy prevention, preterm labor, other direct causes, indirect causes, and health policies and systems. Most research questions concerned the effectiveness of clinical interventions, including drugs (42.6%), nonpharmacologic interventions (16.3%), and health system (14.7%). It is possible to identify gaps in the maternal health research by using this approach. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Electronic reminders improve procedure documentation compliance and professional fee reimbursement.

    PubMed

    Kheterpal, Sachin; Gupta, Ruchika; Blum, James M; Tremper, Kevin K; O'Reilly, Michael; Kazanjian, Paul E

    2007-03-01

    Medicolegal, clinical, and reimbursement needs warrant complete and accurate documentation. We sought to identify and improve our compliance rate for the documentation of arterial catheterization in the perioperative setting. We first reviewed 12 mo of electronic anesthesia records to establish a baseline compliance rate for arterial catheter documentation. Residents and Certified Registered Nurse Anesthetists were randomly assigned to a control group and experimental group. When surgical incision and anesthesia end were documented in the electronic record keeper, a reminder routine checked for an invasive arterial blood pressure tracing. If a case used an arterial catheter, but no procedure note was observed, the resident or Certified Registered Nurse Anesthetist assigned to the case was sent an automated alphanumeric pager and e-mail reminder. Providers in the control group received no pager or e-mail message. After 2 mo, all staff received the reminders. A baseline compliance rate of 80% was observed (1963 of 2459 catheters documented). During the 2-mo study period, providers in the control group documented 152 of 202 (75%) arterial catheters, and the experimental group documented 177 of 201 (88%) arterial lines (P < 0.001). After all staff began receiving reminders, 309 of 314 arterial lines were documented in a subsequent 2 mo period (98%). Extrapolating this compliance rate to 12 mo of expected arterial catheter placement would result in an annual incremental $40,500 of professional fee reimbursement. The complexity of the tertiary care process results in documentation deficiencies. Inexpensive automated reminders can drastically improve compliance without the need for complicated negative or positive feedback.

  18. The prevalence of, and factors related to, compliance with glove utilization among nurses in Hospital Universiti Sains Malaysia.

    PubMed

    Naing, L; Nordin, R; Musa, R

    2001-09-01

    Increasing risk of HIV infections among health care workers has been a continuing concern. The study was designed to identify the compliance of glove utilization, and factors related to non-compliance. A sample of 150 staff nurses were recruited from the study population of 550 nurses in Hospital Universiti Sains Malaysia. Data were collected by using a structured self-administered questionnaires. The response rate was 98.4%. The study revealed a low compliance (13.5%) of glove utilization (for all 9 procedures), which varied among different procedures (27-97%). Younger nurses and those with shorter duration of working experience had better knowledge of Universal Precautions. Nurses in intensive care unit and operation theatre were better in both knowledge and compliance of glove utilization. The three commonest misconceptions were identified as "selective use of gloves for high risk groups and suspected cases", and "tendency to depend on HIV prevalence". Nurses reported practical problems including administrative and personal related such as "stock irregularity" (46%), "glove not available at the emergency sites" (44%), and "reduction of tactile sensation" (39%). It was concluded that poor knowledge and practical problems were possible responsible factors for the low compliance. A good training for nurses comprising principle and practice of Universal Precautions, updated knowledge of blood and body fluid borne infections and risk and its management, will probably improve the compliance.

  19. Pulse wave velocity in the microcirculation reflects both vascular compliance and resistance: Insights from computational approaches.

    PubMed

    Pan, Qing; Wang, Ruofan; Reglin, Bettina; Fang, Luping; Yan, Jing; Cai, Guolong; Kuebler, Wolfgang M; Pries, Axel R; Ning, Gangmin

    2018-05-05

    PWV is the speed of pulse wave propagation through the circulatory system. mPWV emerges as a novel indicator of hypertension, yet it remains unclear how different vascular properties affect mPWV. We aim to identify the biomechanical determinants of mPWV. A 1D model was used to simulate PWV in a rat mesenteric microvascular network and, for comparison, in a human macrovascular arterial network. Sensitivity analysis was performed to assess the relationship between PWV and vascular compliance and resistance. The 1D model enabled adequate simulation of PWV in both micro- and macrovascular networks. Simulated arterial PWV changed as a function of vascular compliance but not resistance, in that arterial PWV varied at a rate of 0.30 m/s and -6.18 × 10 -3  m/s per 10% increase in vascular compliance and resistance, respectively. In contrast, mPWV depended on both vascular compliance and resistance, as it varied at a rate of 2.79 and -2.64 cm/s per 10% increase in the respective parameters. The present study identifies vascular compliance and resistance in microvascular networks as critical determinants of mPWV. We anticipate that mPWV can be utilized as an effective indicator for the assessment of microvascular biomechanical properties. © 2018 John Wiley & Sons Ltd.

  20. Integrating environmental gap analysis with spatial conservation prioritization: a case study from Victoria, Australia.

    PubMed

    Sharafi, Seyedeh Mahdieh; Moilanen, Atte; White, Matt; Burgman, Mark

    2012-12-15

    Gap analysis is used to analyse reserve networks and their coverage of biodiversity, thus identifying gaps in biodiversity representation that may be filled by additional conservation measures. Gap analysis has been used to identify priorities for species and habitat types. When it is applied to identify gaps in the coverage of environmental variables, it embodies the assumption that combinations of environmental variables are effective surrogates for biodiversity attributes. The question remains of how to fill gaps in conservation systems efficiently. Conservation prioritization software can identify those areas outside existing conservation areas that contribute to the efficient covering of gaps in biodiversity features. We show how environmental gap analysis can be implemented using high-resolution information about environmental variables and ecosystem condition with the publicly available conservation prioritization software, Zonation. Our method is based on the conversion of combinations of environmental variables into biodiversity features. We also replicated the analysis by using Species Distribution Models (SDMs) as biodiversity features to evaluate the robustness and utility of our environment-based analysis. We apply the technique to a planning case study of the state of Victoria, Australia. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Compliance through pollution prevention opportunity assessments at Edwards AFB -- Development, results and lessons learned

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Beutelman, H.P.; Lawrence, A.

    1999-07-01

    Edwards Air Force Base (AFB), located in the Mojave Desert of southern California, is required to comply with environmental requirements for air pollution emissions, hazardous waste disposal, and clean water. The resources required to meet these many compliance requirements represents an ever increasing financial burden to the base, and to the Department of Defense. A recognized superior approach to environmental management is to achieve compliance through a proactive pollution prevention (P2) program which mitigates, and when possible, eliminates compliance requirements and costs, while at the same time reducing pollution released to the environment. At Edwards AFB, the Environmental Management Officemore » P2 Branch developed and implemented a strategy that addresses this concept, better known as Compliance Through Pollution Prevention (CTP2). At the 91st AWMA Annual Meeting and Exhibition, Edwards AFB presented a paper on its strategy and implementation of its CTP2 concept. Part of that strategy and implementation included accomplishment of process specific focused P2 opportunity assessments (OAs). Starting in 1998, Edwards AFB initiated a CTP2 OA project where OAs were targeted on those operational processes, identified as compliance sites, that contributed most to the compliance requirements and costs at Edwards AFB. The targeting of these compliance sites was accomplished by developing a compliance matrix that prioritized processes in accordance with an operational risk management approach. The Edwards AFB CTP2 PPOA project is the first of its kind within the Air Force Material Command, and is serving as a benchmark for establishment of the CTP2 OA process.« less

  2. Spectacle-wear compliance in school children in Concepción Chile.

    PubMed

    von-Bischhoffshausen, Fernando Barria; Muñoz, Beatriz; Riquelme, Ana; Ormeño, Maria Jose; Silva, Juan Carlos

    2014-12-01

    Although international policies promote programs for correction of refractive errors in school children, recent studies report low compliance with respect to spectacle wear. Our aim was to assess spectacle-wear compliance and identify associated visual factors among children participating in Chile's school spectacle provision program. A total of 270 school children were prescribed spectacles and monitored after 1 year. Visual acuity, refractive error, reasons for not wearing spectacles, and self-reported visual function were assessed. Compliance is reported as the proportion of children wearing spectacles at the 1-year visit. Factors associated with compliance and reasons for not wearing spectacles were examined using contingency table analyses. Logistic models were constructed to assess independently associated factors. Only 204 children (76%) participated in the 1-year follow-up. Mean age was 10 years (range 4-19 years); 58% were girls, 42% boys. Overall compliance was 58%. Spectacle use was independently associated with age and refractive error. Older children were less likely to be compliant (odds ratio, OR, 0.8, 95% confidence interval, CI, 0.76-0.92/year of increasing age). Compared with children with refractions of -0.75 to +0.75 diopters, both myopic and hyperopic children were more compliant (OR 4.93, 95% CI 2.28-10.67 and OR 2.37, 95% CI 1.06-5.31, respectively). Primary reasons for not wearing spectacles included breakage/loss in younger children, and disliking the appearance in teenagers. We found greater compliance in spectacle wear than that reported in most published studies. Guidelines for provision of children's spectacles should consider excluding children with mild refractive error and improving spectacle quality and appearance.

  3. Compliance With Point-of-Sale Tobacco Control Policies in School-Adjacent Neighborhoods in Mumbai, India.

    PubMed

    Mistry, Ritesh; Pimple, Sharmila; Mishra, Gauravi; Gupta, Prakash C; Pednekar, Mangesh; Ranz-Schleifer, Naomi; Shastri, Surendra

    2015-09-21

    Purpose . We assessed factors associated with tobacco vendor compliance with India's Cigarettes and Other Tobacco Products Act (COTPA) provisions regulating tobacco sales and point-of-sale (POS) environments. Design . Study design was a cross-sectional random sample of tobacco vendors in Mumbai, India (2010). Setting . School-adjacent neighborhoods were the study setting. Subjects . Study subjects were tobacco vendors (n = 436). Measures . Face-to-face interviews, and audits of POS environments were used to assess compliance. Analysis . Factors associated with compliance were identified using logistic regression. Results . About 4% of vendors were fully compliant. Although 80% reported compliance with the ban on tobacco sales to minors, only 10% displayed signage about the ban. About 84% were compliant with the two-tobacco advertisement limit; of those displaying advertisements, 67% were compliant with size limits, 68% with content restrictions, and 8% with health warning requirements. Knowledge about fines for noncompliance was associated with compliance with the ban on sales to minors (odds ratio [OR], 2.12; 95% confidence interval [CI], 1.26, 3.56) and signage requirement (OR, 4.42; 95% CI, 1.76, 11.13). Greater compliance with the two-advertisement limit was associated with higher store income from tobacco (OR, .26; 95% CI, .09, .73) and lower neighborhood socioeconomic status (p < .01); the latter was associated with advertisement size limits compliance (p < .05). Conclusions . Compliance with COTPA provisions was low. Interventions modifying vendor knowledge about provisions and fines may increase compliance, and they should target stores that are reliant on tobacco sales.

  4. Review of oil and HNS accidental spills in Europe: identifying major environmental monitoring gaps and drawing priorities.

    PubMed

    Neuparth, T; Moreira, S M; Santos, M M; Reis-Henriques, M A

    2012-06-01

    The European Atlantic area has been the scene of a number of extensive shipping incidents with immediate and potential long-term impacts to marine ecosystems. The occurrence of accidental spills at sea requires an effective response that must include a well executed monitoring programme to assess the environmental contamination and damage of the affected marine habitats. Despite a number of conventions and protocols developed by international and national authorities that focused on the preparedness and response to oil and HNS spills, much remains to be done, particularly in relation to the effectiveness of the environmental monitoring programmes implemented after oil and HNS spills. Hence, the present study reviews the status of the environmental monitoring programmes established following the major spill incidents over the last years in European waters, aiming at identifying the key monitoring gaps and drawing priorities for an effective environmental monitoring of accidental spills. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Compliance of nursing home residents with a nutrient- and energy-dense oral nutritional supplement determines effects on nutritional status.

    PubMed

    Jobse, I; Liao, Y; Bartram, M; Delantonio, K; Uter, W; Stehle, P; Sieber, C C; Volkert, D

    2015-03-01

    Administration of oral nutritional supplements (ONS) is an effective strategy to treat and avoid malnutrition, a persisting issue in nursing homes. However, little is known about compliance in the NH population. This study aimed to analyse the effects of compliance of NH residents with a low-volume, nutrient- and energy-dense ONS on nutritional status and to identify residents' characteristics associated with compliance. Randomized, controlled trial in nursing homes. 87 nursing home residents (87 ± 6y, 91% female) with malnutrition or at risk of malnutrition were randomly allocated to an intervention group (IG) receiving 2 x 125 ml ONS (2.4 kcal/ml)/d for 12 weeks, or the control group (CG) with usual care. ONS intake was recorded daily and compliance calculated. Low and high compliance were defined as ≤ 30% and ≥ 80% of provided ONS actually consumed, respectively. Body weight (BW), BMI, upper-arm (UAC) and calf-circumference (CC) and MNA-SF were assessed at baseline and after 12 weeks. Associations between compliance and changes of nutritional parameters and residents' characteristics were analysed. Compliance was high in 35.7% and low in 28.6% of the IG (n=42). BW change was significantly higher in subjects with high compliance (median +3.0 (interquartile range +2.1;+3.8) kg, n=15) than in those with low compliance (-0.2 (-2.2;+1.6) kg, n=12) and CG (-0.1 (-1.2; +0.6) kg, n=35; p<0.001), and significantly correlated with compliance in IG (r=0.691; p<0.001). Significant differences and correlations were also identified for BMI, UAC and MNA-SF. High compliance was more often observed in residents with malnutrition (66.7 vs. 27.3%) and chewing difficulties (77.8 vs. 24.2%) than in those without these conditions. Low compliance was more prevalent in residents who were immobile (45.0 vs. 13.6%), depressed (33.3 vs. 6.7%) or had gastrointestinal complaints (50.0 vs. 17.9%) (all p<0.05). A high compliance of nursing home residents with a low volume, nutrient- and

  6. Effective health care corporate compliance.

    PubMed

    Saum, T B; Byassee, J

    2000-01-01

    The pace and intensity of oversight and investigation of health care organizations has greatly increased at all levels. Well run organizations with ethical management committed to following all laws and regulations are still at risk for compliance violations and punitive penalties. Under the Federal Sentencing Guidelines, organizations with an "effective" corporate compliance program may receive reduced penalties. The seven components of an effective program as defined in the guidelines are: (1) Standards and procedures; (2) oversight responsibilities; (3) employee training; (4) monitoring and auditing; (5) reporting systems; (6) enforcement and discipline; and (7) response and prevention. Lack of a compliance program needlessly exposes the organization to an avoidable risk of damage from non-compliance--whether intentional or not. Moreover, an effective program can contribute to the efficient operation of the organization and be a key piece of its corporate culture.

  7. Medical management of primary open-angle glaucoma: Best practices associated with enhanced patient compliance and persistency.

    PubMed

    Kulkarni, Sadhana V; Damji, Karim F; Buys, Yvonne M

    2008-02-02

    Primary open angle glaucoma is a chronic optic neuropathy often requiring lifelong treatment. Patient compliance, adherence and persistence with therapy play a vital role in improved outcomes by reducing morbidity and the economic consequences that are associated with disease progression. A literature review including searches of The Cochrane Library, MEDLINE, PubMed, conference proceedings, and bibliographies of identified articles reveals the enormous public health burden in various populations due to the impact of glaucoma associated visual impairment on the overall quality of life eg, fear of blindness, inability to work in certain occupations, driving restrictions, motor vehicle accidents, falls, and general health status. Providing specific definitions for the frequently misunderstood terms "compliance, persistence and adherence" with reference to medication use is central not only for monitoring patients' drug dosing histories and clinical outcomes but also for subsequent research. In this review article, a summary of the advantages/disadvantages including cost-effectiveness of various medical approaches to glaucoma treatment, techniques employed for measuring patient compliance and actual patient preferences for therapy are outlined. We conclude by identifying the key barriers to ongoing treatment and suggest some best practices to enhance compliance and persistence.

  8. Medical management of primary open-angle glaucoma: Best practices associated with enhanced patient compliance and persistency

    PubMed Central

    Kulkarni, Sadhana V; Damji, Karim F; Buys, Yvonne M

    2008-01-01

    Primary open angle glaucoma is a chronic optic neuropathy often requiring lifelong treatment. Patient compliance, adherence and persistence with therapy play a vital role in improved outcomes by reducing morbidity and the economic consequences that are associated with disease progression. A literature review including searches of The Cochrane Library, MEDLINE, PubMed, conference proceedings, and bibliographies of identified articles reveals the enormous public health burden in various populations due to the impact of glaucoma associated visual impairment on the overall quality of life eg, fear of blindness, inability to work in certain occupations, driving restrictions, motor vehicle accidents, falls, and general health status. Providing specific definitions for the frequently misunderstood terms “compliance, persistence and adherence” with reference to medication use is central not only for monitoring patients’ drug dosing histories and clinical outcomes but also for subsequent research. In this review article, a summary of the advantages/disadvantages including cost-effectiveness of various medical approaches to glaucoma treatment, techniques employed for measuring patient compliance and actual patient preferences for therapy are outlined. We conclude by identifying the key barriers to ongoing treatment and suggest some best practices to enhance compliance and persistence. PMID:19920977

  9. Bridging the gap in care for children through the clinical nurse leader.

    PubMed

    O'Grady, Erin L; VanGraafeiland, Brigit

    2012-01-01

    Care coordination has been identified as a gap in the nursing care of children and families who experience an encounter within the health care system. The educational preparation of the clinical nurse leader (CNL) enables the CNL to address many gaps found in health care. Current evidence suggests various gaps in care, as reported by patients, families, nurses, and other health care providers. Identified gaps in care include problems with communication, coordination, education, research, advocacy, psychological and social support, and the needs of siblings. The CNL may improve quality of care for children through efficient care coordination by acting as a liaison and advocate between the patient, family, and health care team to bridge gaps in the current practices of care.

  10. Factors influencing vaccination compliance in peri-urban Gambian children.

    PubMed

    Hanlon, P; Byass, P; Yamuah, M; Hayes, R; Bennett, S; M'Boge, B H

    1988-02-01

    The vaccination status of 251 children aged 12-18 months in two peri-urban Gambian communities was determined from their health cards. Two subgroups were identified: children who were fully vaccinated, and those who had received less than half their vaccinations. The social and environmental circumstances of these children were investigated to detect factors which were associated with poor vaccination compliance. Mothers of well vaccinated children were more inclined to bring them for non-curative services. Mothers of poorly vaccinated children had a poorer knowledge of the diseases against which their children should be vaccinated and they also had a more superstitious view of disease causation. Those children who showed poor compliance came from larger families. In the poorly vaccinated group both parents were less well educated and there was a trend towards poorer literacy.

  11. Estimations and predictors of non-compliance in switchers to reduced nicotine content cigarettes.

    PubMed

    Nardone, Natalie; Donny, Eric C; Hatsukami, Dorothy K; Koopmeiners, Joseph S; Murphy, Sharon E; Strasser, Andrew A; Tidey, Jennifer W; Vandrey, Ryan; Benowitz, Neal L

    2016-12-01

    Clinical trials on the impact and safety of reduced nicotine content cigarettes (RNCs) are ongoing, and an important methodological concern is participant compliance with smoking only RNCs. Our aims were to measure non-compliance biochemically with urine cotinine (COT) and total nicotine equivalents (TNEs), compare with self-reported non-compliance and identify associated covariates. Secondary analysis of a double-blind, parallel, randomized clinical trial. Research centers from the United States, enrolling participants from June 2013 to July 2014. Volunteer sample of 242 participants (55% Caucasian), average age of 41.2 years, smoking at least five cigarettes per day (CPD). Smoking very low nicotine cigarettes (VLNCs; 0.4 mg nicotine/g tobacco) for 6 weeks. The primary outcome was biochemically verified non-compliance, measured as thresholds of COT/CPD and TNE/CPD ratios, considering changes in nicotine content from conventional levels to VLNCs, and as an absolute threshold of week 6 TNEs. Self-reported non-compliance was measured via daily phone calls. Key predictors included age, sex, race, menthol preference, nicotine metabolite ratio, time to first cigarette, dependence, CPD, TNEs, tar level and cigarette evaluation. Estimates of non-compliance with smoking the VLNCs exclusively include: the biochemical ratios (both 78%), the week 6 TNE threshold (76%) and self-report (39%). Of the key covariates, age, dependence and cigarette evaluations of satisfaction were significant; for age, younger participants more likely to be non-compliant [P = 0.01; odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.96-0.99]. Dependence was associated significantly with self-reported non-compliance (P = 0.01; OR = 1.28, 95% CI = 1.06-1.55). Cigarette evaluations of satisfaction were associated significantly with non-compliance (P = 0.001; OR = 0.71, 95% CI = 0.61-0.82). Among smokers volunteering to smoke only very low nicotine cigarettes for 6 weeks, non-compliance

  12. Enforcement of continuous compliance with air quality regulations

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Harrington, C.W.

    1985-01-01

    The compliance of stationary air-pollution sources with air quality regulations is examined. Contrary to the predictions of economic models of enforcement, sources are generally in continuous compliance with the regulations. An alternative voluntary compliance model of enforcement is proposed, in which regulated sources are penalized not for violations, but for failing to return to compliance when a violation is discovered. It is argued that continuous compliance is a bargain struck between the source and the regulatory agency, in which the agency agrees to avoid use of penalties in return for the source's good faith attempts to maintain compliance.

  13. Estimating Gender Wage Gaps

    ERIC Educational Resources Information Center

    McDonald, Judith A.; Thornton, Robert J.

    2011-01-01

    Course research projects that use easy-to-access real-world data and that generate findings with which undergraduate students can readily identify are hard to find. The authors describe a project that requires students to estimate the current female-male earnings gap for new college graduates. The project also enables students to see to what…

  14. Integrated Compliance Information System (ICIS)

    EPA Pesticide Factsheets

    The purpose of ICIS is to meet evolving Enforcement and Compliance business needs for EPA and State users by integrating information into a single integrated data system that supports both management and programmatic requirements of the Enforcement and Compliance programs.

  15. HRS/NSA 2014 Survey of Atrial Fibrillation and Stroke: Gaps in Knowledge and Perspective, Opportunities for Improvement.

    PubMed

    Frankel, David S; Parker, Sarah E; Rosenfeld, Lynda E; Gorelick, Philip B

    2015-08-01

    The prevalence of atrial fibrillation (AF) is substantial and increasing. Stroke is common in AF and can have devastating consequences. Oral anticoagulants are effective in reducing stroke risk, but are underutilized. We sought to characterize the impact of stroke on AF patients and their caregivers, gaps in knowledge and perspective between physicians and patients, and barriers to effective communication and optimal anticoagulation use. A survey was administered to AF patients with and without history of stroke, caregivers of stroke survivors, and physicians across the range of specialties caring for AF and stroke patients. While AF patients (n = 499) had limited knowledge about stroke, they expressed great desire to learn more and take action to reduce their risk. They were often dissatisfied with the education they had received and desired high-quality written materials. Stroke survivors (n = 251) had poor functional outcomes and often underestimated the burden of caring for them. Caregivers (n = 203) also wished they had received more information about reducing stroke risk before their survivor's event. They commonly felt overwhelmed and socially isolated. Physicians (n = 504) did not prescribe anticoagulants as frequently as recommended by guidelines. Concerns about monitoring anticoagulation and patient compliance were commonly reported barriers. Physicians may underestimate patient willingness to take anticoagulants. We identified significant knowledge gaps among patients, caregivers, and physicians in relation to AF and stroke. Furthermore, gaps in perspective often lead to suboptimal communication and decision making. Increased education and better communication between all stakeholders are needed to reduce the impact of stroke in AF. Copyright © 2015 Heart Rhythm Society and National Stroke Association. Published by Elsevier Inc. All rights reserved.

  16. HRS/NSA 2014 survey of atrial fibrillation and stroke: Gaps in knowledge and perspective, opportunities for improvement.

    PubMed

    Frankel, David S; Parker, Sarah E; Rosenfeld, Lynda E; Gorelick, Philip B

    2015-08-01

    The prevalence of atrial fibrillation (AF) is substantial and increasing. Stroke is common in AF and can have devastating consequences. Oral anticoagulants are effective in reducing stroke risk, but are underutilized. We sought to characterize the impact of stroke on AF patients and their caregivers, gaps in knowledge and perspective between physicians and patients, and barriers to effective communication and optimal anticoagulation use. A survey was administered to AF patients with and without history of stroke, caregivers of stroke survivors, and physicians across the range of specialties caring for AF and stroke patients. While AF patients (n = 499) had limited knowledge about stroke, they expressed great desire to learn more and take action to reduce their risk. They were often dissatisfied with the education they had received and desired high-quality written materials. Stroke survivors (n = 251) had poor functional outcomes and often underestimated the burden of caring for them. Caregivers (n = 203) also wished they had received more information about reducing stroke risk before their survivor's event. They commonly felt overwhelmed and socially isolated. Physicians (n = 504) did not prescribe anticoagulants as frequently as recommended by guidelines. Concerns about monitoring anticoagulation and patient compliance were commonly reported barriers. Physicians may underestimate patient willingness to take anticoagulants. We identified significant knowledge gaps among patients, caregivers, and physicians in relation to AF and stroke. Furthermore, gaps in perspective often lead to suboptimal communication and decision making. Increased education and better communication between all stakeholders are needed to reduce the impact of stroke in AF. Copyright © 2015 Heart Rhythm Society and National Stroke Association. Published by Elsevier Inc. All rights reserved.

  17. An Institutional Program to Increase Compliance with Clinicaltrials.gov Requirements.

    PubMed

    Kelly-Pumarol, Issis; Andrews, Joseph E

    2018-01-01

    Recent National Institutes of Health policy changes have expanded the number of research studies that must be registered in clinicaltrials.gov beyond the requirements of the Food and Drug Administration Amendments Act of 2007. The International Committee of Medical Journal Editors has also adopted a policy that requires registration of research in a public database. The goal was to increase the transparency of research by reporting the original endpoints of a study, and to discern whether primary endpoints were excluded in subsequent publications. Efforts to increase openness and accountability in clinical trials are likely to strengthen public trust. However, first investigators and study staff must be educated about the requirements, and staff must be prepared to offer support to researchers in navigating the clinicaltrials.gov system. For academic institutions, maintaining compliance requires continuous oversight so that problems can be identified centrally and addressed with investigators. At Wake Forest University Health Sciences, because researchers often did not realize they were out of compliance, we implemented a program to assist them and provide oversight. We introduced standard operating procedures, provided education and assistance to investigators, and engaged leadership about consequences of compliance, resulting in increased budget support for a full-time employee in this role. As a result of these changes, compliance increased from 22% to 92% over 4 months. These approaches may help other institutions become compliant with registration requirements more quickly.

  18. Suboptimal compliance with evidence-based guidelines in patients with traumatic brain injuries.

    PubMed

    Shafi, Shahid; Barnes, Sunni A; Millar, D; Sobrino, Justin; Kudyakov, Rustam; Berryman, Candice; Rayan, Nadine; Dubiel, Rosemary; Coimbra, Raul; Magnotti, Louis J; Vercruysse, Gary; Scherer, Lynette A; Jurkovich, Gregory J; Nirula, Raminder

    2014-03-01

    Evidence-based management (EBM) guidelines for severe traumatic brain injuries (TBIs) were promulgated decades ago. However, the extent of their adoption into bedside clinical practices is not known. The purpose of this study was to measure compliance with EBM guidelines for management of severe TBI and its impact on patient outcome. This was a retrospective study of blunt TBI (11 Level I trauma centers, study period 2008-2009, n = 2056 patients). Inclusion criteria were an admission Glasgow Coma Scale score ≤ 8 and a CT scan showing TBI, excluding patients with nonsurvivable injuries-that is, head Abbreviated Injury Scale score of 6. The authors measured compliance with 6 nonoperative EBM processes (endotracheal intubation, resuscitation, correction of coagulopathy, intracranial pressure monitoring, maintaining cerebral perfusion pressure ≥ 50 cm H2O, and discharge to rehabilitation). Compliance rates were calculated for each center using multivariate regression to adjust for patient demographics, physiology, injury severity, and TBI severity. The overall compliance rate was 73%, and there was wide variation among centers. Only 3 centers achieved a compliance rate exceeding 80%. Risk-adjusted compliance was worse than average at 2 centers, better than average at 1, and the remainder were average. Multivariate analysis showed that increased adoption of EBM was associated with a reduced mortality rate (OR 0.88; 95% CI 0.81-0.96, p < 0.005). Despite widespread dissemination of EBM guidelines, patients with severe TBI continue to receive inconsistent care. Barriers to adoption of EBM need to be identified and mitigated to improve patient outcomes.

  19. Compliance with indoor tanning bans for minors among businesses in the USA.

    PubMed

    Choy, Courtney C; Cartmel, Brenda; Clare, Rachel A; Ferrucci, Leah M

    2017-12-01

    Indoor tanning is a known risk factor for skin cancer and is especially dangerous for adolescents. Some states have passed indoor tanning bans for minors, but business compliance with the bans is not well understood. Thus far, studies have assessed ban compliance in one or two states at a time. This study aimed to assess compliance with indoor tanning bans for minors and knowledge of dangers and benefits of tanning among indoor tanning businesses. Female research assistants posing as minors telephoned a convenience sample of 412 businesses in 14 states with tanning bans for minors under age 17 or 18. We evaluated differences in compliance by census region and years since ban was implemented and differences in reported dangers and benefits by compliance. Most (80.1%) businesses told the "minor" caller she could not use the tanning facilities. Businesses in the south and in states with more recent bans were less compliant. Among those (n = 368) that completed the full interview, 52.2% identified burning and 20.1% mentioned skin cancer as potential dangers. However, 21.7% said dangers were no worse than the sun and 10.3% denied any dangers. Stated benefits included vitamin D (27.7%), social/cosmetic (27.2%), and treats skin diseases (26.4%), with only 4.9% reporting no benefits. While most businesses followed the indoor tanning ban when a minor called, one-fifth did not. Many stated inaccurate health claims. Additional enforcement or education might increase compliance with indoor tanning bans and action is needed to prevent businesses from stating false health information.

  20. Compliance With a Comprehensive Antibiotic Protocol Improves Infection Incidence in Pediatric Spine Surgery.

    PubMed

    Vandenberg, Curt; Niswander, Cameron; Carry, Patrick; Bloch, Nikki; Pan, Zhaoxing; Erickson, Mark; Garg, Sumeet

    A multidisciplinary task force, designated Target Zero, has developed protocols for prevention of surgical site infection (SSI) for spine surgery at our institution. The purpose of this study was to evaluate how compliance with an antibiotic bundle impacts infection incidences in pediatric spine surgery. After institutional review board approval, a consecutive series of 511 patients (517 procedures) who underwent primary spine procedures from 2008 to 2012 were retrospectively reviewed to identify patients who developed SSI. Patients were followed for a minimum of 90 days postoperatively. Compliance data were collected prospectively in 511 consecutive patients and a total of 517 procedures. Three criteria were required for antibiotic bundle compliance: appropriate antibiotics completely administered within 1 hour before incision, antibiotics appropriately redosed intraoperatively for blood loss and time, and antibiotics discontinued within 24 hours postoperatively. A multivariable logistic regression analysis was used to test the association between compliance and the development of an infection. Overall antibiotic bundle compliance rate was 85%. After adjusting for risk category, estimated blood loss, and study year, the likelihood of an infection was increased in the noncompliant group compared with the compliant group (adjusted odds ratio: 3.0, 95% CI, 0.96-9.47, P=0.0587). When expressed as the number needed to treat, strict adherence to antibiotic bundle compliance prevented 1 SSI within 90 days of surgery for every 26 patients treated with the antibiotic bundle. Reasons for noncompliance included failure to infuse preoperative antibiotics 1 hour before incision (10.3%), failure to redose antibiotics intraoperatively based on time or blood loss (5.5%), and failure to discontinue antibiotics within 24 hours postoperatively (1.9%). Compliance with a comprehensive antibiotic protocol can lead to meaningful reductions in SSI incidences in pediatric spine surgery

  1. Compliance and coping potential of cancer patients treated in liaison-consultation psychiatry.

    PubMed

    Grube, Michael

    2006-01-01

    To investigate the impact of psychiatric illness, aggression, and other covarying variables on the compliance and coping potential of cancer patients treated in liaison-consultation psychiatry. The study involves 270 cancer patients who were admitted to the oncology ward for diagnosis and treatment. Each patient took part in a psychiatric consultation. We used the Transplant Evaluation Rating Scale (TERS), which provides a system for differentially recording the patient's compliance and coping potential (total score for the TERS items 3-10). Following standardization using the basic psychooncological documentation (PO-BADO), the demographic variables were recorded. We also identified the internal processes which each patient used to deal with the disease using criteria established by Kübler-Ross as well as the phases of cancer experience according to Fawzy. Twenty-three variables were checked for their relationship to the coping and compliance potential. For 13 of these, the Mann-Whitney U-test or Spearmann-Rank correlation calculated exceeded the required Bonferroni-adjusted significance level. The calculation of an ordinal regression model containing these significant single variables showed that the following variables are associated with a lower compliance and coping potential according to their estimate (Beta-value): aggression as the dominant form of dealing internally with cancer (Kübler-Ross), pre-existing DSM IV Axis 1 psychiatric disorders, carcinoma-induced psychiatric disorders, necessity of treatment with neuroleptics and male gender. Acceptance as the dominant form of dealing internally with cancer (Kübler-Ross) is strongly associated with a higher compliance and coping potential. The results show that the compliance and coping potential of oncological in-patients can be comprehensively described by the Transplant Evaluation Rating Scale. The instruments of measurement used in the study are also useful for describing risk factors associated with

  2. 7 CFR 923.61 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 923.61 Section 923.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... COUNTIES IN WASHINGTON Order Regulating Handling Miscellaneous Provisions § 923.61 Compliance. Except as...

  3. 7 CFR 987.76 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 987.76 Section 987.76 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... RIVERSIDE COUNTY, CALIFORNIA Order Regulating Handling Miscellaneous Provisions § 987.76 Compliance. No...

  4. 7 CFR 946.71 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 946.71 Section 946.71 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Miscellaneous Provisions § 946.71 Compliance. Except as provided in this...

  5. 5 CFR 724.105 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Compliance. 724.105 Section 724.105 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED... 2002 Reimbursement of Judgement Fund § 724.105 Compliance. An agency's failure to reimburse the...

  6. 7 CFR 956.89 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 956.89 Section 956.89 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... VALLEY OF SOUTHEAST WASHINGTON AND NORTHEAST OREGON Miscellaneous Provisions § 956.89 Compliance. No...

  7. 7 CFR 906.52 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 906.52 Section 906.52 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... RIO GRANDE VALLEY IN TEXAS Order Regulating Handling Miscellaneous Provisions § 906.52 Compliance...

  8. 7 CFR 987.76 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 987.76 Section 987.76 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... RIVERSIDE COUNTY, CALIFORNIA Order Regulating Handling Miscellaneous Provisions § 987.76 Compliance. No...

  9. 7 CFR 922.61 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 922.61 Section 922.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... IN WASHINGTON Order Regulating Handling Miscellaneous Provisions § 922.61 Compliance. Except as...

  10. 5 CFR 724.105 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Compliance. 724.105 Section 724.105 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED... 2002 Reimbursement of Judgement Fund § 724.105 Compliance. An agency's failure to reimburse the...

  11. 7 CFR 946.71 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 946.71 Section 946.71 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Miscellaneous Provisions § 946.71 Compliance. Except as provided in this...

  12. 7 CFR 906.52 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 906.52 Section 906.52 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... RIO GRANDE VALLEY IN TEXAS Order Regulating Handling Miscellaneous Provisions § 906.52 Compliance...

  13. 7 CFR 956.89 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 956.89 Section 956.89 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... VALLEY OF SOUTHEAST WASHINGTON AND NORTHEAST OREGON Miscellaneous Provisions § 956.89 Compliance. No...

  14. 7 CFR 917.64 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 917.64 Section 917.64 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... CALIFORNIA Order Regulating Handling Miscellaneous Provisions § 917.64 Compliance. Each shipper shall comply...

  15. 7 CFR 917.64 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 917.64 Section 917.64 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... CALIFORNIA Order Regulating Handling Miscellaneous Provisions § 917.64 Compliance. Each shipper shall comply...

  16. 7 CFR 923.61 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 923.61 Section 923.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... COUNTIES IN WASHINGTON Order Regulating Handling Miscellaneous Provisions § 923.61 Compliance. Except as...

  17. 7 CFR 922.61 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 922.61 Section 922.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... IN WASHINGTON Order Regulating Handling Miscellaneous Provisions § 922.61 Compliance. Except as...

  18. Factors affecting compliance with preventive treatment for tuberculosis at Mistassini Lake, Quebec, Canada.

    PubMed

    Rideout, M; Menzies, R

    1994-02-01

    Non-compliance is the most important cause of failure of anti-tuberculous therapy throughout the world. In 1990 and 1991, an outbreak of tuberculosis occurred on the Mistassini Cree territory in Northern Quebec, Canada, and a number of cases of active tuberculosis occurred among known tuberculin-positive contacts who were non-compliant with preventive therapy. To better understand the factors affecting compliance with preventive treatment, a review of patients prescribed preventive treatment over the past 10 y was conducted. A freely-translated, interviewer-administered questionnaire was used to measure personal/lifestyle factors and knowledge/attitudes about tuberculosis. Clinic dossiers were reviewed to assess compliance. One hundred and two (102) subjects prescribed preventive treatment between 1981 and 1991 were interviewed, of whom 33.7% were judged to have been compliant. The most significant factor associated with compliance with preventive therapy was year of therapy. Between 1981 and 1985, 78% completed treatment, compared to less than 20% since 1986 (p < .0001). The major factor identified as associated with this sudden change was a shift in responsibility for tuberculosis treatment follow-up from native community health workers to non-native nurses in 1985/86. We conclude that tuberculosis control programs must be tailored to take into account the importance of cultural factors in promoting compliance with therapy.

  19. Pharmaceutic factors affecting pediatric compliance.

    PubMed

    Mattar, M E; Markello, J; Yaffe, S J

    1975-01-01

    Evaluation of treatment given at home was studied in children with otitis media who were seen in an outpatient clinic. Full compliance was present in only 5% of the initial 100 patients (Study A). Practical factors limiting their compliance included inadequate dispensing of medication at drug stores, 15%; incorrect therapy schedule, 36%; early termination, 37%; spilled medicine, 7%; therapy shared, 5%. Because of these findings, a plan was implemented (Study B) in which hospital pharmacy personnel gave patient families verbal and written instructions for administering medications that were dispensed, together with a calibrated measuring device and a calendar to record doses taken. Full compliance was raised to 51% in this pilot group (of 33 patients) as compared with 8.5% in 20 concurrent controls who went to neighborhood drug stores. The importance of detailed therapy instructions is stressed. The potential role of the pharmacist in improving compliance is demonstrated.

  20. School Counselors: Closing Achievement Gaps and Writing Results Reports

    ERIC Educational Resources Information Center

    Hartline, Julie; Cobia, Debra

    2012-01-01

    Charged with closing the achievement gap for marginalized students, school counselors need to be able to identify gaps, develop interventions, evaluate effectiveness, and share results. This study examined 100 summary results reports submitted by school counselors after having received four days of training on the ASCA National Model. Findings…

  1. Identifying and Understanding the Gaps in Care Experienced by Adolescent and Young Adult Cancer Patients at the University of Iowa Hospitals and Clinics.

    PubMed

    Mobley, Erin M; Foster, Kristin J; Terry, William W

    2018-06-20

    In an effort to counteract the differences in improvement in survival rates of adolescents and young adults (AYA), compared to other age groups with cancer, the University of Iowa Hospitals and Clinics established an AYA cancer program. This study was conducted to gather feedback from AYAs in an effort to generate actionable data for program development. The target population included patients aged 13-31 treated for malignancy in one of the following disease sites: central nervous system, leukemia, lymphoma, neuroendocrine, sarcoma, and thyroid. A series of four focus groups was held to identify and describe gaps in care and provide suggestions for program development. A convergent parallel mixed-methods design was used. Qualitative data were derived from focus group discussion and free-response survey questions, while quantitative data were derived from objective survey questions and electronic medical record data. Across the four focus groups, 24 different AYAs participated, ranging from 8 to 19 individuals per session. Topics discussed included the following: communication, treatment experience, and overall AYA program; finances, work and school, and late effects; relationships, emotions, and spirituality; and body image, infertility, sexuality, risky behavior, and suicide. The results of the analyses corroborated what makes AYAs different from other age groups. The primary theme identified was the unique relationships of AYAs, which can be thought of along a continuum. Information obtained from these analyses has been used to inform specific projects within the development of the AYA program to address patient-identified gaps. For AYAs, the importance of relationships along a continuum should be considered when developing an AYA program, in addition to potential policy or health service research utilization in the future.

  2. The correlates of preschoolers' compliance with screen recommendations exist across multiple domains.

    PubMed

    Hinkley, Trina; Salmon, Jo; Okely, Anthony D; Crawford, David

    2013-09-01

    To investigate the individual, social and physical environment correlates of preschool children's compliance with Australian/Canadian and American Academy of Pediatrics (AAP) screen recommendations. An Ecological Model (EM) was used to identify constructs potentially associated with children's screen time. In 2008-2009, parents in Melbourne, Australia, reported their child's screen time and on a range of potential correlates. Children (n = 935; 54% boys, mean age 4.54 ± 0.70 years) were assessed as meeting or not meeting each of the screen recommendations. Logistic regression assessed bivariable and multivariable associations. In total, 15 explanatory variables, across the three domains of the EM were associated with boys' and/or girls' compliance with either Australian/Canadian or AAP recommendations. Correlates varied by sex and recommendation. Maternal television viewing time was the only consistent correlate for both boys' and girls' compliance with both recommendations. No demographic groups were identified as being less likely to comply with screen recommendations. Public health programs should take account of the sex-specific nature of correlates of preschool children's screen time. Preschool children across all demographic groups need support to engage in less screen use. Parents may benefit from education and parenting skills to minimize potentially harmful effects of excessive screen time for their child. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Filling the gap between identified neuroblasts and neurons in crustaceans adds new support for Tetraconata

    PubMed Central

    Ungerer, Petra; Scholtz, Gerhard

    2007-01-01

    The complex spatio-temporal patterns of development and anatomy of nervous systems play a key role in our understanding of arthropod evolution. However, the degree of resolution of neural processes is not always detailed enough to claim homology between arthropod groups. One example is neural precursors and their progeny in crustaceans and insects. Pioneer neurons of crustaceans and insects show some similarities that indicate homology. In contrast, the differentiation of insect and crustacean neuroblasts (NBs) shows profound differences and their homology is controversial. For Drosophila and grasshoppers, the complete lineage of several NBs up to formation of pioneer neurons is known. Apart from data on median NBs no comparable results exist for Crustacea. Accordingly, it is not clear where the crustacean pioneer neurons come from and whether there are NBs lateral to the midline homologous to those of insects. To fill this gap, individual NBs in the ventral neuroectoderm of the crustacean Orchestia cavimana were labelled in vivo with a fluorescent dye. A partial neuroblast map was established and for the first time lineages from individual NBs to identified pioneer neurons were established in a crustacean. Our data strongly suggest homology of NBs and their lineages, providing further evidence for a close insect–crustacean relationship. PMID:18048285

  4. 23 CFR 230.415 - Consolidated compliance reviews.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... which will actually be reviewed onsite shall be determined. Compliance determinations shall only reflect..., OFCCP has reserved the responsibility for compliance determinations on crafts covered by part I of the... adequate coordination of activities at every stage of the review process. (7) Compliance determinations...

  5. 23 CFR 230.415 - Consolidated compliance reviews.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... which will actually be reviewed onsite shall be determined. Compliance determinations shall only reflect..., OFCCP has reserved the responsibility for compliance determinations on crafts covered by part I of the... adequate coordination of activities at every stage of the review process. (7) Compliance determinations...

  6. 23 CFR 230.415 - Consolidated compliance reviews.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... which will actually be reviewed onsite shall be determined. Compliance determinations shall only reflect..., OFCCP has reserved the responsibility for compliance determinations on crafts covered by part I of the... adequate coordination of activities at every stage of the review process. (7) Compliance determinations...

  7. 41 CFR 60-300.60 - Compliance evaluations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Compliance evaluations... MEDAL VETERANS General Enforcement and Complaint Procedures § 60-300.60 Compliance evaluations. (a) OFCCP may conduct compliance evaluations to determine if the contractor is taking affirmative action to...

  8. 40 CFR 60.22 - Publication of guideline documents, emission guidelines, and final compliance times.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... for the design, installation, and startup of identified control systems. (5) An emission guideline... different emission guidelines or compliance times or both for different sizes, types, and classes of...

  9. 7 CFR 915.61 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 915.61 Section 915.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 915.61 Compliance. Except as provided in this part, no person...

  10. 7 CFR 916.61 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 916.61 Section 916.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 916.61 Compliance. Except as provided in this part, no person...

  11. 7 CFR 927.71 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 927.71 Section 927.71 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Miscellaneous Provisions § 927.71 Compliance. Except as provided in § 927.65...

  12. 40 CFR 725.70 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Compliance. 725.70 Section 725.70 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT REPORTING REQUIREMENTS AND REVIEW PROCESSES FOR MICROORGANISMS Administrative Procedures § 725.70 Compliance. (a) Failure...

  13. 7 CFR 947.81 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 947.81 Section 947.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 947.81 Compliance. Except as provided in this subpart, no handler shall handle...

  14. 40 CFR 725.70 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Compliance. 725.70 Section 725.70 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT REPORTING REQUIREMENTS AND REVIEW PROCESSES FOR MICROORGANISMS Administrative Procedures § 725.70 Compliance. (a) Failure...

  15. 7 CFR 905.81 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 905.81 Section 905.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... TANGELOS GROWN IN FLORIDA Order Regulating Handling Miscellaneous Provisions § 905.81 Compliance. Except as...

  16. 7 CFR 925.61 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 925.61 Section 925.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... SOUTHEASTERN CALIFORNIA Miscellaneous Provisions § 925.61 Compliance. Except as provided in this part, no...

  17. 7 CFR 953.76 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 953.76 Section 953.76 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... STATES Order Regulating Handling Miscellaneous Provisions § 953.76 Compliance. Except as provided in this...

  18. 7 CFR 932.65 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 932.65 Section 932.65 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 932.65 Compliance. Except as provided in this part, no person...

  19. 7 CFR 905.81 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 905.81 Section 905.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... TANGELOS GROWN IN FLORIDA Order Regulating Handling Miscellaneous Provisions § 905.81 Compliance. Except as...

  20. 7 CFR 966.81 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 966.81 Section 966.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 966.81 Compliance. Except as provided in this subpart, no...

  1. 7 CFR 953.76 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 953.76 Section 953.76 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... STATES Order Regulating Handling Miscellaneous Provisions § 953.76 Compliance. Except as provided in this...

  2. 7 CFR 985.64 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 985.64 Section 985.64 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements....64 Compliance. No person shall handle oil except in conformity with the provisions of this part. ...

  3. 7 CFR 947.81 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 947.81 Section 947.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 947.81 Compliance. Except as provided in this subpart, no handler shall handle...

  4. 7 CFR 985.64 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 985.64 Section 985.64 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements....64 Compliance. No person shall handle oil except in conformity with the provisions of this part. ...

  5. 7 CFR 955.80 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 955.80 Section 955.80 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 955.80 Compliance. No handler shall handle Vidalia onions except in conformity with...

  6. 7 CFR 932.65 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 932.65 Section 932.65 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 932.65 Compliance. Except as provided in this part, no person...

  7. 7 CFR 966.81 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 966.81 Section 966.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 966.81 Compliance. Except as provided in this subpart, no...

  8. 7 CFR 927.71 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 927.71 Section 927.71 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Miscellaneous Provisions § 927.71 Compliance. Except as provided in § 927.65...

  9. 7 CFR 955.80 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 955.80 Section 955.80 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 955.80 Compliance. No handler shall handle Vidalia onions except in conformity with...

  10. 7 CFR 916.61 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 916.61 Section 916.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 916.61 Compliance. Except as provided in this part, no person...

  11. 7 CFR 925.61 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 925.61 Section 925.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... SOUTHEASTERN CALIFORNIA Miscellaneous Provisions § 925.61 Compliance. Except as provided in this part, no...

  12. 7 CFR 915.61 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 915.61 Section 915.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Miscellaneous Provisions § 915.61 Compliance. Except as provided in this part, no person...

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

    PubMed

    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.

  14. Physicians’ influence on breast cancer patient compliance

    PubMed Central

    Kostev, Karel; Waehlert, Lilia; Jockwig, Achim; Jockwig, Barbara; Hadji, Peyman

    2014-01-01

    In recent years there have been major advances in the treatment of breast cancer. However, taking the prescribed medication for a sufficient period of time is crucial to the success of any therapy. Thus far, no database-based studies have been published in German-speaking countries empirically examining the influence of the physician on the compliance of patients. The aim of this study is to investigate, quantify, and critically discuss the effect treating physicians have on the compliance of their breast cancer patients. Patients with a confirmed breast cancer diagnosis who started therapy (tamoxifen or aromatase inhibitors) between January 2001 and December 2011 were selected from the representative IMS Disease Analyzer database and analyzed with regard to their compliance. Practices were grouped into two categories concerning the compliance of all treated patients. A regression model showed that a breast cancer patient who is treated in a practice with a trend toward poor compliance has a nearly 60% higher risk for treatment discontinuation than would be the case in a practice with good compliance. It shows how important it is to motivate physicians to strive toward good compliance rates. PMID:24454275

  15. Promoting compliance: the patient-provider partnership.

    PubMed

    Wilson, B M

    1995-07-01

    Compliance has been defined traditionally in terms of how well a patient follows through with the recommendations of a health care provider. Patient education has often consisted of a one-way communication of provider to patient. This article advocates a multifaceted approach to compliance issues in which patients and health care providers set mutually agreed upon treatment goals. These goals must be consistent with patients' priorities and lifestyles. Patient compliance issues are examined in the context of three theoretical frameworks: (1) the Health-Belief Model, (2) Locus of Control Theory, and (3) Piaget's Theory of Cognitive Development. The insights gained from these models are then used to provide practical suggestions for enhancing compliance.

  16. 41 CFR 60-741.60 - Compliance evaluations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Compliance evaluations... evaluations. (a) OFCCP may conduct compliance evaluations to determine if the contractor maintains... with this part during employment. A compliance evaluation may consist of any one or any combination of...

  17. 48 CFR 22.406-7 - Compliance checking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Compliance checking. 22... Involving Construction 22.406-7 Compliance checking. (a) General. The contracting officer shall make checks and investigations on all contracts covered by this subpart as may be necessary to ensure compliance...

  18. A quality improvement programme to increase compliance with an anti-infective prescribing policy

    PubMed Central

    Thakkar, Kandarp; Gilchrist, Mark; Dickinson, Edward; Benn, Jonathan; Franklin, Bryony Dean; Jacklin, Ann; Adeniran, Shola; Ali, Alisha; Brannigan, Eimear; Bamford, Kathy; Lam-Chong, Kelly; Dickinson, Edward; Gilchrist, Mark; Jacklin, Ann; Lawson, Wendy; Mehta, Roopal; Newsholme, William; Rana, Ambreen; Reynolds, Sarah; Sanderson, Frances; Wei Tan, Xin; Thakkar, Kandarp; Bracey, Gemma

    2011-01-01

    Objectives The UK Department of Health has made recommendations on safe and appropriate prescribing of anti-infectives. In response, we reviewed our anti-infective policies to ensure they were in line with best practice. As a result, a new adult anti-infective policy was launched. To help facilitate its implementation, a quality improvement programme was established, with the aim of achieving >90% compliance with the new policy. Methods Patients under the care of the medical admissions teams who had been prescribed one or more systemic anti-infectives between January and November 2008 were included in the study. Study pharmacists collected data daily on all patients, including the anti-infective(s) prescribed and indication(s) documented on either the patient's drug prescription chart or health records. A definition of compliance was developed, which required documented indication(s) and associated anti-infectives to match the anti-infective policy. A baseline compliance level was established; we then implemented a series of interventions using the plan-do-study-act (‘PDSA’) approach to monitor and improve compliance. Three overlapping intervention phases were retrospectively identified: raising awareness; education; and weekly feedback of results in the form of run charts distributed to medical teams. Results Over the 11 month study period, compliance with the policy increased from 30% to 71%. Since 2008, we have seen the average compliance increase year-on-year to over 90% in 2010 using a sustainable once weekly data collection model. Conclusions This study shows that it is possible to use quality improvement methodology to support antimicrobial stewardship within existing resources and suggests that an improvement in policy compliance can be both achieved and sustained. PMID:21642650

  19. 7 CFR 984.65 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 984.65 Section 984.65 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Reserve Walnuts § 984.65 Compliance. Except as provided in this subpart, no person shall...

  20. 40 CFR 766.5 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Compliance. 766.5 Section 766.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT DIBENZO-PARA-DIOXINS/DIBENZOFURANS General Provisions § 766.5 Compliance. Any person who fails or refuses to...

  1. 7 CFR 983.80 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 983.80 Section 983.80 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements..., ARIZONA, AND NEW MEXICO Miscellaneous Provisions § 983.80 Compliance. Except as provided in this part, no...

  2. 7 CFR 930.80 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 930.80 Section 930.80 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 930.80 Compliance. Except as provided in this part, no person may handle cherries...

  3. 7 CFR 920.61 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 920.61 Section 920.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 920.61 Compliance. (a) Except as provided in this part, no person shall handle...

  4. 7 CFR 920.61 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 920.61 Section 920.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 920.61 Compliance. (a) Except as provided in this part, no person shall handle...

  5. 7 CFR 958.81 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 958.81 Section 958.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Compliance. No handler shall handle onions the handling of which has been prohibited or otherwise limited by...

  6. 7 CFR 929.66 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 929.66 Section 929.66 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Compliance. Except as provided in this part, no person shall handle cranberries, the handling of which has...

  7. 7 CFR 929.66 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 929.66 Section 929.66 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Compliance. Except as provided in this part, no person shall handle cranberries, the handling of which has...

  8. 7 CFR 924.61 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 924.61 Section 924.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... § 924.61 Compliance. Except as provided in this part, no person shall handle prunes, the shipment of...

  9. 7 CFR 958.81 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 958.81 Section 958.81 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Compliance. No handler shall handle onions the handling of which has been prohibited or otherwise limited by...

  10. 46 CFR 340.9 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false Compliance. 340.9 Section 340.9 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PRIORITY USE AND ALLOCATION OF... NATIONAL DEFENSE RELATED OPERATIONS § 340.9 Compliance. Pursuant to section 103 of the Defense Production...

  11. 7 CFR 996.74 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 996.74 Section 996.74 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Compliance. (a) A handler or importer shall be subject to withdrawal of inspection services, for a period of...

  12. 7 CFR 984.65 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Compliance. 984.65 Section 984.65 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Reserve Walnuts § 984.65 Compliance. Except as provided in this subpart, no person shall...

  13. 14 CFR 213.6 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Compliance. 213.6 Section 213.6 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TERMS, CONDITIONS AND LIMITATIONS OF FOREIGN AIR CARRIER PERMITS § 213.6 Compliance. Any violation...

  14. 46 CFR 340.9 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Compliance. 340.9 Section 340.9 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PRIORITY USE AND ALLOCATION OF... NATIONAL DEFENSE RELATED OPERATIONS § 340.9 Compliance. Pursuant to section 103 of the Defense Production...

  15. 7 CFR 996.74 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 996.74 Section 996.74 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Compliance. (a) A handler or importer shall be subject to withdrawal of inspection services, for a period of...

  16. 7 CFR 930.80 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 930.80 Section 930.80 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 930.80 Compliance. Except as provided in this part, no person may handle cherries...

  17. 14 CFR 213.6 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Compliance. 213.6 Section 213.6 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TERMS, CONDITIONS AND LIMITATIONS OF FOREIGN AIR CARRIER PERMITS § 213.6 Compliance. Any violation...

  18. 40 CFR 766.5 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Compliance. 766.5 Section 766.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT DIBENZO-PARA-DIOXINS/DIBENZOFURANS General Provisions § 766.5 Compliance. Any person who fails or refuses to...

  19. 7 CFR 924.61 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Compliance. 924.61 Section 924.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... § 924.61 Compliance. Except as provided in this part, no person shall handle prunes, the shipment of...

  20. Learning in context: identifying gaps in research on the transfer of medical communication skills to the clinical workplace.

    PubMed

    van den Eertwegh, Valerie; van Dulmen, Sandra; van Dalen, Jan; Scherpbier, Albert J J A; van der Vleuten, Cees P M

    2013-02-01

    In order to reduce the inconsistencies of findings and the apparent low transfer of communication skills from training to medical practice, this narrative review identifies some main gaps in research on medical communication skills training and presents insights from theories on learning and transfer to broaden the view for future research. Relevant literature was identified using Pubmed, GoogleScholar, Cochrane database, and Web of Science; and analyzed using an iterative procedure. Research findings on the effectiveness of medical communication training still show inconsistencies and variability. Contemporary theories on learning based on a constructivist paradigm offer the following insights: acquisition of knowledge and skills should be viewed as an ongoing process of exchange between the learner and his environment, so called lifelong learning. This process can neither be atomized nor separated from the context in which it occurs. Four contemporary approaches are presented as examples. The following shift in focus for future research is proposed: beyond isolated single factor effectiveness studies toward constructivist, non-reductionistic studies integrating the context. Future research should investigate how constructivist approaches can be used in the medical context to increase effective learning and transition of communication skills. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. Increasing Compliance of Children with Autism: Effects of Programmed Reinforcement for High-Probability Requests and Varied Inter-Instruction Intervals

    ERIC Educational Resources Information Center

    Pitts, Laura; Dymond, Simon

    2012-01-01

    Research on the high-probability (high-p) request sequence shows that compliance with low-probability (low-p) requests generally increases when preceded by a series of high-p requests. Few studies have conducted formal preference assessments to identify the consequences used for compliance, which may partly explain treatment failures, and still…

  2. The significance of compliance and persistence in the treatment of diabetes, hypertension and dyslipidaemia: a review

    PubMed Central

    Cramer, J A; Benedict, Á; Muszbek, N; Keskinaslan, A; Khan, Z M

    2008-01-01

    Objectives To review studies of patient compliance/persistence with cardiovascular or antidiabetic medication published since the year 2000; to compare the methods used to measure compliance/persistence across studies; to compare reported compliance/persistence rates across therapeutic classes and to assess whether compliance/persistence correlates with clinical outcomes. Methods English language papers published between January 2000 and November 2005 investigating patient compliance/persistence with cardiovascular or antidiabetic medication were identified through searches of the MEDLINE and EMBASE databases. Definitions and measurements of compliance/persistence were compared across therapeutic areas using contingency tables. Results Of the 139 studies analysed, 32% focused on hypertension, 27% on diabetes and 13% on dyslipidaemia. The remainder covered coronary heart disease and cardiovascular disease (CVD) in general. The most frequently reported measure of compliance was the 12-month medication possession ratio (MPR). The overall mean MPR was 72%, and the MPR did not differ significantly between treatment classes (range: 67–76%). The average proportion of patients with an MPR of > 80% was 59% overall, 64% for antihypertensives, 58% for oral antidiabetics, 51% for lipid-lowering agents and 69% in studies of multiple treatments, again with no significant difference between treatment classes. The average 12-month persistence rate was 63% and was similar across therapeutic classes. Good compliance had a positive effect on outcome in 73% of the studies examining clinical outcomes. Conclusions Non-compliance with cardiovascular and antidiabetic medication is a significant problem, with around 30% of days ‘on therapy’ not covered by medication and only 59% of patients taking medication for more than 80% of their days ‘on therapy’ in a year. Good compliance has a positive effect on clinical outcome, suggesting that the management of CVD may be improved by

  3. Compliance with clinical pathways for inpatient care in Chinese public hospitals.

    PubMed

    He, Xiao Yan; Bundorf, M Kate; Gu, Jian Jun; Zhou, Ping; Xue, Di

    2015-10-06

    The National Health and Family Planning Commission of China has issued more than 400 clinical pathways to improve the effectiveness and efficiency of medical care delivered by public hospitals in China. The aim of our study is to determine whether patient care is compliant with national clinical pathways in public general hospitals of Pudong New Area in Shanghai. We identified the clinical pathways established by the National Health and Family Planning Commission of China for 5 common conditions (community-acquired pneumonia, acute myocardial infarction (AMI), heart failure, cesarean section, type-2 diabetes). We randomly selected patients with each condition admitted to one of 7 public general hospitals in Pudong New Area in China in January, 2013. We identified key process indicators (KPIs) for each pathway and, based on chart review for each patient, determined whether the patient's care was compliant for each indicator. We calculated the proportion of care which was compliant with clinical pathways for each indicator, the average proportion of indicators that were met for each patient, and the proportion of patients whose care was compliant for all measures. For selected indicators, we compared compliance rates among hospitals in our study with those from other countries. Average compliance rates across the KPIs for each condition ranged from 61 % for AMI to 89 % for pneumonia. The percent of patient receiving fully compliant care ranged from 0 for AMI and heart failure to 39 % for pneumonia. Compared to the compliance rate for process indicators in the hospitals of other countries, some rates in the hospitals that we audited were higher, but some were lower. Few patients received care that complied with all the pathways for each condition. The reasons for low compliance with national clinical pathways and how to improve clinical quality in public hospitals of China need to be further explored.

  4. Biennial Environmental Compliance Report (2010-2012)

    EPA Pesticide Factsheets

    This Biennial Environmental Compliance Report (BECR) documents United States (U.S.) Department of Energy (DOE) compliance with environmental regulations applicable to the Waste Isolation Pilot Plant (WIPP) facility.

  5. Identifying the translational gap in the evaluation of drug-induced QTc interval prolongation

    PubMed Central

    Chain, Anne SY; Dubois, Vincent FS; Danhof, Meindert; Sturkenboom, Miriam CJM; Della Pasqua, Oscar

    2013-01-01

    Aims Given the similarities in QTc response between dogs and humans, dogs are used in pre-clinical cardiovascular safety studies. The objective of our investigation was to characterize the PKPD relationships and identify translational gaps across species following the administration of three compounds known to cause QTc interval prolongation, namely cisapride, d, l-sotalol and moxifloxacin. Methods Pharmacokinetic and pharmacodynamic data from experiments in conscious dogs and clinical trials were included in this analysis. First, pharmacokinetic modelling and deconvolution methods were applied to derive drug concentrations at the time of each QT measurement. A Bayesian PKPD model was then used to describe QT prolongation, allowing discrimination of drug-specific effects from other physiological factors known to alter QT interval duration. A threshold of ≥10 ms was used to explore the probability of prolongation after drug administration. Results A linear relationship was found to best describe the pro-arrhythmic effects of cisapride, d,l-sotalol and moxifloxacin both in dogs and in humans. The drug-specific parameter (slope) in dogs was statistically significantly different from humans. Despite such differences, our results show that the probability of QTc prolongation ≥10 ms in dogs nears 100% for all three compounds at the therapeutic exposure range in humans. Conclusions Our findings indicate that the slope of PKPD relationship in conscious dogs may be used as the basis for the prediction of drug-induced QTc prolongation in humans. Furthermore, the risk of QTc prolongation can be expressed in terms of the probability associated with an increase ≥10 ms, allowing direct inferences about the clinical relevance of the pro-arrhythmic potential of a molecule. PMID:23351036

  6. 40 CFR 264.99 - Compliance monitoring program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... be based on a compliance monitoring program developed to meet the requirements of this section. (i... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Compliance monitoring program. 264.99... Releases From Solid Waste Management Units § 264.99 Compliance monitoring program. An owner or operator...

  7. 9 CFR 2.100 - Compliance with standards.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Compliance with standards. 2.100 Section 2.100 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Compliance With Standards and Holding Period § 2.100 Compliance with...

  8. 9 CFR 2.100 - Compliance with standards.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Compliance with standards. 2.100 Section 2.100 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Compliance With Standards and Holding Period § 2.100 Compliance with...

  9. 9 CFR 2.100 - Compliance with standards.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Compliance with standards. 2.100 Section 2.100 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Compliance With Standards and Holding Period § 2.100 Compliance with...

  10. 9 CFR 2.100 - Compliance with standards.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Compliance with standards. 2.100 Section 2.100 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Compliance With Standards and Holding Period § 2.100 Compliance with...

  11. Impact and management of chemotherapy/radiotherapy-induced nausea and vomiting and the perceptual gap between oncologists/oncology nurses and patients: a cross-sectional multinational survey.

    PubMed

    Vidall, Cheryl; Fernández-Ortega, Paz; Cortinovis, Diego; Jahn, Patrick; Amlani, Bharat; Scotté, Florian

    2015-11-01

    Chemotherapy/radiotherapy-induced nausea and vomiting (CINV/RINV) can affect half of oncology patients, significantly impacting daily life. Nausea without vomiting has only recently been thought of as a condition in its own right. As such, the incidence of nausea is often underestimated. This survey investigated the incidence and impact of CINV/RINV in patients compared with estimations of physicians/oncology nurses to determine if there is a perceptual gap between healthcare professionals and patients. An online research survey of physicians, oncology nurses and patients was conducted across five European countries. Participants had to have experience prescribing/recommending or have received anti-emetic medication for CINV/RINV treatment. Questionnaires assessed the incidence and impact of CINV/RINV, anti-emetic usage and compliance, and attribute importance of anti-emetic medication. A total of 947 (375 physicians, 186 oncology nurses and 386 patients) participated in this survey. The incidence of nausea was greater than vomiting: 60 % of patients reported nausea alone, whereas 18 % reported vomiting. Physicians and oncology nurses overestimated the incidence of CINV/RINV but underestimated its impact on patients' daily lives. Only 38 % of patients reported full compliance with physicians'/oncology nurses' guidelines when self-administering anti-emetic medication. Leading factors for poor compliance included reluctance to add to a pill burden and fear that swallowing itself would induce nausea/vomiting. There is a perceptual gap between healthcare professionals and patients in terms of the incidence and impact of CINV/RINV. This may lead to sub-optimal prescription of anti-emetics and therefore management of CINV/RINV. Minimising the pill burden and eliminating the requirement to swallow medication could improve poor patient compliance with anti-emetic regimens.

  12. 12 CFR 1770.5 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Compliance. 1770.5 Section 1770.5 Banks and Banking OFFICE OF FEDERAL HOUSING ENTERPRISE OVERSIGHT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SAFETY AND SOUNDNESS EXECUTIVE COMPENSATION § 1770.5 Compliance. (a) An employment agreement or contract...

  13. 45 CFR 1305.10 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Compliance. 1305.10 Section 1305.10 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH..., RECRUITMENT, SELECTION, ENROLLMENT AND ATTENDANCE IN HEAD START § 1305.10 Compliance. A grantee's failure to...

  14. 45 CFR 1305.10 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Compliance. 1305.10 Section 1305.10 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH..., RECRUITMENT, SELECTION, ENROLLMENT AND ATTENDANCE IN HEAD START § 1305.10 Compliance. A grantee's failure to...

  15. 12 CFR 1770.5 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Compliance. 1770.5 Section 1770.5 Banks and Banking OFFICE OF FEDERAL HOUSING ENTERPRISE OVERSIGHT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SAFETY AND SOUNDNESS EXECUTIVE COMPENSATION § 1770.5 Compliance. (a) An employment agreement or contract...

  16. 31 CFR 206.7 - Compliance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Compliance. 206.7 Section 206.7 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT..., AND OPERATION OF THE CASH MANAGEMENT IMPROVEMENTS FUND § 206.7 Compliance. (a) The Service will...

  17. 31 CFR 206.7 - Compliance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Compliance. 206.7 Section 206.7 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT..., AND OPERATION OF THE CASH MANAGEMENT IMPROVEMENTS FUND § 206.7 Compliance. (a) The Service will...

  18. 40 CFR 60.32d - Compliance times.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Compliance times. 60.32d Section 60.32d... PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Sulfuric Acid Production Units § 60.32d Compliance times. Sulfuric acid production units. Planning, awarding of contracts, and...

  19. 40 CFR 60.32d - Compliance times.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 7 2012-07-01 2012-07-01 false Compliance times. 60.32d Section 60.32d... PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Sulfuric Acid Production Units § 60.32d Compliance times. Sulfuric acid production units. Planning, awarding of contracts, and...

  20. 40 CFR 60.32d - Compliance times.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 6 2011-07-01 2011-07-01 false Compliance times. 60.32d Section 60.32d... PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Sulfuric Acid Production Units § 60.32d Compliance times. Sulfuric acid production units. Planning, awarding of contracts, and...