Compliance Measurements Research Articles

Handoff Tool Improves Transitions from the Operating Room to the Neonatal Intensive Care Unit.

Standardized handoffs reduce medical errors and prevent adverse events or near misses. This article describes a quality improvement initiative implementing a unique standardized handoff tool and process to transition from the operating room to the neonatal intensive care unit (NICU) at a level-four regional center with many inpatients requiring surgical intervention. Before this project, there was no standardized handoff tool or process for postsurgical transitions. The primary aim was to achieve 80% compliance with completing a structured postoperative OR to NICU handoff tool within 12 months of implementation. An interdisciplinary team developed and implemented a standardized NICU postoperative handoff tool and process that requires face-to-face communication, defines team members who should be present, and highlights communication with the family. In addition, the handoff tool compliance and process measures were monitored, evaluated, and audited. Although not consistent, we achieved eighty percent compliance with the outcome measures using the handoff tool. We did not sustain 80% of appropriate providers present at handoff. In addition, insufficient data assess overall parental satisfaction with the surgical experience. Although improved, the process measure of immediate postoperative family updates did not reach the targeted goal. However, the balancing measure of staff experience and satisfaction did improve. Implementing a standardized handoff tool and process with an interdisciplinary and interdepartmental collaboration improves critical patient transitions from the operating room to the NICU.

The role of mindfulness and compassion in early adults' subsequent mental health, coping and compliance with health guidelines during the COVID‐19 pandemic: A prospective longitudinal study

AbstractThe present study explored prospective links between trait mindfulness and compassion on subsequent coping and compliance with Centers for Disease Control (CDC) guidelines and indirect effects via well‐being and internalized distress during the COVID‐19 pandemic. The study included N = 736 US college students who participated in a three‐wave longitudinal study across a single academic year. The first two assessment waves took place in 2018 and 2019, respectively, while the third wave took place in May 2020 during the COVID‐19 pandemic. Participants completed self‐report measures of trait mindfulness, compassion, well‐being, internalized distress, coping, and compliance with CDC health guidelines. Results of a series of autoregressive, cross‐lagged panel models revealed that trait mindfulness was associated with better coping via indirect effects of greater well‐being and lower internalized distress. Greater compassion was linked with greater adherence to CDC guidelines. Findings suggest that trait mindfulness and compassion may play a role in college students' coping and compliance during the pandemic.

Investigating the Role of Individual Differences in Adherence to Cognitive Training.

Consistent with research across several domains, intervention adherence is associated with desired outcomes. Our study investigates adherence, defined by participants' commitment to, persistence with, and compliance with an intervention's regimen, as a key mechanism underlying cognitive training effectiveness. We examine this relationship in a large and diverse sample comprising 4,775 adults between the ages of 18 and 93. We test the predictive validity of individual difference factors, such as age, gender, cognitive capability (i.e., fluid reasoning and working memory), grit, ambition, personality, self-perceived cognitive failures, socioeconomic status, exercise, and education on commitment to and persistence with a 20-session cognitive training regimen, as measured by the number of sessions completed. Additionally, we test the relationship between compliance measures: (i) spacing between training sessions, as measured by the average time between training sessions, and (ii) consistency in the training schedule, as measured by the variance in time between training sessions, with performance trajectories on the training task. Our data suggest that none of these factors reliably predict commitment to, persistence with, or compliance with cognitive training. Nevertheless, the lack of evidence from the large and representative sample extends the knowledge from previous research exploring limited, heterogenous samples, characterized by older adult populations. The absence of reliable predictors for commitment, persistence, and compliance in cognitive training suggests that nomothetic factors may affect program adherence. Future research will be well served to examine diverse approaches to increasing motivation in cognitive training to improve program evaluation and reconcile the inconsistency in findings across the field.

Sensitivity, repeatability and reproducibility study with a leg prototype of a recently developed knee arthrometer: The DYNEELAX®

Sagittal knee laxity is often quantified using arthrometers. Adding rotational laxity and compliance measurements is relatively new and could bring new information for anterior cruciate ligament (ACL) injury diagnosis. The DYNEELAX® is a new knee arthrometer able to evaluate simultaneously tibial translation and rotation. The purpose is to assess the sensitivity, reproducibility and repeatability of the DYNEELAX® with a prototype leg to provide accurate instructions before using it in clinical practice. Sensitivity is studied by varying 7 parameters (positioning and sensors), and reproducibility by repeating measurement series with a group of two experienced operators and a group of two non-experienced operators. Repeatability is assessed throughout the study. The results showed that DYNEELAX® is poorly sensitive to the angle and the position of the displacement sensor, and the angle of the rotation sensor. It is a bit sensitive to positioning of patella and ankle supports. It is very sensitive to the tightening of the patella and ankle supports. It exists a significant difference only between groups (p ​< ​0.001), but there is no significant difference between the two experienced operators (p ​> ​0.215), or between the two non-experienced operators (p ​> ​0.229). Variation coefficients for intra-series are on average inferior to 5% for translation and rotation tests. Then, the DYNEELAX® presented encouraging results with a good accuracy and a good reliability but operators must be careful about positioning.

Optimization of Compliance and Mitigation of Accounting Frauds in American Organizations

It is through fraudulent accounting records that organizations’ annual results invariably lead directors and stakeholders to substantial losses, if not bankruptcy. The literature shows that financial frauds result from improper accounting entries, stemming from the bad intentions and greed of corrupt individuals in top management positions in various businesses. These individuals choose to engage in conduct that harms entire groups composed of companies, workers, and investors, affecting their credibility and integrity in their industry and also impacting professionals in the fields of accounting and auditing. In order to prevent financial frauds, organizations must take preventive measures by adopting good practices in Corporate Governance through the implementation of effective compliance actions, establishing specific and effective objectives among internal controls, and avoiding risks and accounting practices that may negatively impact the organizations. This original article, prepared through bibliographic research, aims to demonstrate that compliance actions contribute to the mitigation of fraud when properly applied in administrative and organizational processes. As a result, it was found that adopting compliance measures within the organizational system is not enough without regular verification of its effectiveness by administrators and managers.

Impact of Brace-Related Stress on Brace Compliance in Adolescent Idiopathic Scoliosis: A Single-Center Comparative Study Using Objective Compliance Measurement and Brace-Related Stress.

This study aimed to investigate the brace compliance and clinical background of patients with adolescent idiopathic scoliosis (AIS) who demonstrate different degrees of psychological brace-related stress. Forty-five patients initiating brace treatment with a Cobb angle between 25° and 45° were included. Patients receiving brace treatment for AIS were administered a questionnaire for brace-related stress (i.e., the Japanese version of the Bad Sobernheim Stress Questionnaire-Brace [JBSSQ-brace]). Based on their scores, we allocated the patients into two stress groups: mild-stress (≥16 points) and below-moderate-stress (<16 points). We investigated the character of brace compliance and brace-related psychological stress in all patients and compared the demographics and brace compliance between both groups. Forty-one of 45 patients completed the study. The mean JBSSQ-brace scores were 18.7±5.1, 19.1±5.2, and 18.7±5.0 points at the 1-month, 4-month, and 1-year follow-ups, respectively. There was no significant change in JBSSQ-brace scores over one year after the brace prescription (P=0.332). There was no difference in-brace compliance between seasons during the first month of brace prescription (P=0.252). Both groups' overall brace compliance was comparable (below-moderate: 17.1±7.1 h/day vs. mild: 20.4±3.0 h/day; P=0.078). The mild-stress group showed better compliance than the below-moderate-stress group on weekdays (below-moderate: 17.0±6.9 h/day vs. mild: 20.5±2.8 h/day; P=0.048) and at nighttime (below-moderate: 82.3%±27.0%/nighttime vs. mild: 93.8%±12.4%/nighttime; P=0.008). Overall, brace compliance was comparable among patients with different brace-related stress, but brace compliance during weekdays and nighttime was significantly better in the mild-stress group.

Spectrum of ascending aortic aneurysms at a peri-urban tertiary hospital: an echocardiography-based study.

Thoracic ascending aortic (TAA) aneurysms are an important cause of disability and death and require early detection for effective management. Currently, there is a paucity of data from Africa pertaining to TAA aneurysms. This study describes the spectrum of TAA aneurysms at a peri-urban tertiary hospital. A descriptive retrospective study based on clinical and echocardiographic imaging data of patients with TAA aneurysms from October 2017-October 2022. Advanced strain imaging was performed to measure left ventricular (LV) basal, apical, and global longitudinal strain as well as circumferential strain (CS) of the ascending aorta as a proxy measurement of aortic compliance. The study comprised 139 cases of TAA aneurysms (52.5% females) with a mean age of 50 ± 14.8 years with 45 age and gender matched controls. Most cases (95%) were of African ethnicity. The main etiologies were hypertension (41.7%), HIV (36.6%), connective tissue disease (10.7%), congenital (2.2%) and mixed pathologies (8.6%). Two-thirds of patients (69.7%) presented in heart failure, 10% presented with aortic dissection. Thirty percent of the patients were classified as New York Heart Association (NYHA) class I, 59.7% NYHA II, 8.6% NYHA III and two patients NYHA class IV. Echocardiography revealed enlarged aortic dimensions compared to controls (P < 0.001). TAA aneurysms were complicated by severe aortic regurgitation (AR) in half (50.3%) of patients, moderate AR in 25.8%, and mild AR in 14.3%. The mean LV ejection fraction (46.9 ± 12.7%) was reduced compared to controls (P < 0.001). Aortic CS was reduced compared to controls [4.4 (3.2-6.2) % vs. 9.0 (7.1-13.4) %, P < 0.001]. Aortic stiffness was higher in the aortic aneurysm group compared to controls (15.39 ± 20.65 vs. 5.04 ± 2.09, P = 0.001). LV longitudinal strain (-13.9 ± 3.9% vs. 18.1 ± 6.7%), basal CS (-13.9 ± 5.6% vs. -17.9 ± 5.8%) and apical CS (-8.7 ± 8.5% vs. -30.6 ± 3.8%) were reduced compared to controls (P < 0.001). Most patients were on diuretic and anti-remodeling therapy. Surgery was performed in 29.4% and overall mortality was 7.9%. Mortality for acute aortic dissection was 40%. TAA aneurysms associated with hypertension and HIV are common in this predominantly African female population and are associated with considerable morbidity and mortality. Two-dimensional echocardiography and advanced strain imaging are potential tools for detecting and risk stratifying TAA aneurysms.

СОЦИАЛЬНО-ПЕДАГОГИЧЕСКИЕ ТЕХНОЛОГИИ ЦЕННОСТНОГО ОРИЕНТИРОВАНИЯ И СОЦИАЛИЗАЦИИ: СИНЕРГЕТИЧЕСКИЙ ПОДХОД

Introduction. Scientists tend to think that synergy, analyzing the "chaos -order" relationship in different spheres of social and natural world, acquires a special role in understanding modern society and the position of a person in it. The concepts of synergy (attractor, bifurcation, self-organization, entropy) and its principles (nonlinearity, instability, openness) applied to the analysis of the social situation of a child's development allow a deeper understanding of the coexistence of processes of randomness and orderliness in the field of his socialization and value orientation. The concepts also allow a new look at both the structure of socio-pedagogical activity and socio-pedagogical technologies. The purpose of the study - to characterize (on the basis of synergetic concepts) the technologies of socio-pedagogical activity aimed at the implementation of interaction with the child. The article presents two types of socio-pedagogical technologies: institutional and individual. Institutional technologies are developed as algorithms based on fixed values - goals, the implementation of which puts being in order, in a state of a more or less stable attractor based on the concept of "how it should be". The synergetic approach promotes the ordering of connections that are significant for the child, bringing the situation of socialization and value orientation into the state of a generally accepted norm. As an evaluation criterion for the transformation of the situation, there is a measure of compliance - non-compliance of the processes of value orientation with generally accepted rules, patterns, norms. Individual technologies are based on the subjective world of inner experiences and are addressed to the meaning of being. Here it is possible to consider the attractor goals as strategic landmarks that allow movement to the result by different trajectories, providing not only the planned, but also an additional result as an element of creativity. This is a creative process of interaction constantly renewed on a personal level to search for the meaning of life. The adequacy – inadequacy of the proposed measures of the uniqueness of the child, the uniqueness of the "case" acts as an evaluation criterion for the situation transformation.

Cross-Cultural Auditing: Challenges in Global Practice

This study explores the challenges faced by auditors in cross-cultural contexts, focusing on cultural biases, communication barriers, regulatory complexities, and trust dynamics. The research aims to investigate the impact of these challenges on audit practice and proposes strategies to mitigate them. A comprehensive literature review is conducted to identify key findings and insights. Methodologically, the study adopts a qualitative approach, drawing on existing literature and case studies to examine real-world examples of cross-cultural auditing challenges. The results highlight the pervasive influence of cultural biases and stereotypes on auditor judgment, the significance of clear and transparent communication in overcoming communication barriers, the complexity of navigating diverse regulatory environments, and the crucial role of trust in facilitating effective audit engagements. Furthermore, the study identifies strategies such as cultural awareness training, language proficiency development, regulatory compliance measures, and relationship-building activities to address these challenges. The findings underscore the importance of cultural intelligence development among audit professionals and emphasize the need for ongoing research and innovation in cross-cultural audit practices.

Impact of a sepsis tracking sheet and emergency department pharmacists on sepsis compliance measures: a prospective emergency department analysis.

Compliance with core sepsis measures in Emergency Departments (ED) remains low, with a limited number of prospective trials highlighting strategies for improvement. A prospective historically case-controlled observational analysis assessing the pre- and post -intervention impact of a sepsis tracking sheet (STS) and the involvement of ED pharmacists. PrimaryThe primary outcome was the improvement in compliance with core sepsis measures. SecondaryThe secondary outcome was to assess the frequency of respiratory interventions and mortality with pre-defined strata of fluid resuscitation (≤10, 10-20, 20-30, 30, ≥30cc/kg of ideal body weight). 194 patients were enrolled over a six -month period with a 9.3% all-cause mortality and a 10.3% rate of new respiratory interventions after fluid boluses. Post-STS implementation compliance of repeat lactate measurement was 88% (vs. 33% pre-STS), broad-spectrum antibiotic administration within 3h of presentation improved to 96% (vs. 20% pre-STS), blood cultures were drawn on 98% of patients (vs. 9% pre-STS), and 30cc/kg fluid boluses were administered to 39% of patients (vs. 25% pre-STS). Of the 18 deaths and 21 respiratory interventions, only two patients fell into both categories. Mortality was highest in those patients that received greater than 30cc/kg of fluid resuscitation (50%). Respiratory interventions were greatest in the strata receiving 10-20cc/kg of fluids (47.6%). Patients receiving the lowest fluid aliquots of <10cc/kg had the highest clinical severity scores but did not have higher rates of historical diagnoses of volume overload. The ED -based implementation of a sepsis tracking sheet and the involvement of dedicated ED pharmacists was effective in improving core measures of sepsis compliance. Patients receiving higher fluid aliquots did not experience higher rates of respiratory interventions, though had higher all-cause mortality. No relationship could be identified between patients getting lower aliquots of fluid and prior diagnoses of volume overload.

The Effects of Emotion Regulation Strategies on Diurnal Cortisol Slope in Older Adults

The ways in which people regulate their emotions may be relevant for their health. Habitual use of suppression has been linked to flatter diurnal cortisol slopes (DCS) in midlife, whereas findings with reappraisal have been mixed. The current study sought to replicate previous suppression and DCS findings, explore reappraisal, and extend the work by examining another, potentially adaptive, emotion regulation strategy, emotional acceptance, and focusing on older adulthood. Participants (Nsubset=90, 53% female, Mage=71.89) from the Stress, Immunity and Emotion Regulation in Aging (SIERA) study completed the Emotion Regulation Questionnaire and Acceptance of Emotions Scale at baseline and provided saliva 3x/day over 10 days (up to 30 samples, mean=29.3, range:4-30). Multilevel models with repeated measures of log-transformed cortisol within person tested trait reappraisal, suppression, and emotional acceptance as moderators of the DCS, adjusted for age and sex. Neither reappraisal (p=.30), suppression (p=.63), nor emotional acceptance (p=.29) moderated the DCS. In addition, there were no main effects of reappraisal, suppression, or emotional acceptance on overall cortisol levels. Despite having high compliance and reliable cortisol measurement with 10 days of testing, we did not replicate previous suppression findings; additionally, neither reappraisal nor emotional acceptance were associated with cortisol in older adults. These null results may be due to differences between how participants perceive their typical use of emotion regulation versus what they actually do in daily life. Future SIERA analyses are planned to test the concordance of emotion regulation measurement using ecological momentary assessments.

Pediatric Eye Care Treatment Rates and Community Compliance to a Spectacle Provision Program in an Underserved School District in San Diego, CA.

The need for early identification and treatment of young children's refractive error needs has become a public health concern. The UCSD Eyemobile for Children (EyeMobile) provides vision screenings and comprehensive eye exams on the Eyemobile among a population of underserved, predominantly Hispanic preschool and elementary school children. The program also provides spectacles for children who fail eye exams due to refractive error. We performed a retrospective cross-sectional analysis of all children screened from 2011 to 2017 by the Eyemobile across 10 San Diego elementary schools. We examined demographics, distance and near visual acuity, autorefraction, stereopsis, and color vision. To measure compliance to our spectacle program, we checked if children who were prescribed spectacles were wearing them, as instructed, at the following year's screening. Differences between compliance measures with respect to school, age, ethnicity, and gender were determined using chi-square analysis, while all other measures were fit to a binary logistic regression to determine statistically significant factors. A total of 12,176 elementary school children were screened between 2011 and 2017. Of these children, 5269 (43.3%) were referred for a comprehensive eye examination. Across six years, 3163 (60.0%) of the children referred completed their eye examinations. There was a significant increase (p < 0.001) in exam completion in the successive years. Exam completion was significantly higher in ten-year-olds (p = 0.0278) and in 3 of the 10 schools (p < 0.0001, p = 0.0027, and p = 0.0309). A total of 1089 (8.9% of screened) children were prescribed spectacles. Of the 409 children that were recorded with the compliance method, 342 (83.6%) were found to be fully compliant and wearing their spectacles as prescribed. The Eyemobile program demonstrated high levels of compliance for both eye examination completion and prescribed spectacle wear in underserved populations in the San Diego region, compared to similar national programs.

The effective crack extension and its implications on the single cantilever beam test for sandwich composites

The response of Single Cantilever Beam sandwich specimens may be analyzed effectively through one-dimensional theories accounting for the actual deformation of the core and its effects on fracture parameters and compliance. The model of a beam on an elastic Winkler foundation describes the detaching facesheet as an Euler–Bernoulli beam resting, in the bonded region, on an elastic foundation which generates oscillating deflections with characteristic length [Formula: see text]. Modified beam theory (MBT) describes the debonded part of the face sheet as a cantilever beam, built-in at the debond tip, with an effective length which is longer than the actual detached length, by a quantity [Formula: see text]. If [Formula: see text] the two models predict the same energy release rate and similar load-point displacements. Effective crack extension and characteristic length depend on the thicknesses and elastic constants of facesheets and core and may be derived through experimental measurements of the specimen compliance at various increments of crack growth, as prescribed by experimental protocols. In the theoretical analyses, [Formula: see text] is typically assumed, either by directly using formulas proposed for other specimens or by calibrating their parameters to case specific finite element results. In this paper, we investigate the applicability of such formulas to a wide selection of sandwich composites for naval and aeronautical applications having thicknesses or materials other than those used for the original fitting; we then highlight their limitations and effects on the design of experimental protocols for material characterization. The applicability of a recent isotropic-elasticity based formula for [Formula: see text] is then verified using extensive data from the literature and novel finite element (FE) results for typical sandwich composites. Finally, a novel elasticity solution for the load-point displacement of a layer on a half plane is derived which supports the test data reduction procedure for [Formula: see text].

Research on the Identification of Incentive Targets for Corporate Compliance

The reform of corporate compliance is rapidly unfolding in pilot regions, as it holds significant importance not only for the governance and prevention of corporate crimes but also for incentivizing companies to initiate compliance measures. To effectively harness the incentives of corporate compliance, the key lies in the identification of appropriate incentive targets. However, in the current judicial practice in China, there are challenges related to the identification of incentive targets, such as a lack of clarity in the scope of identification, ambiguity in the criteria for identification, and deficiencies in the identification process. Therefore, it is necessary to clarify the scope of identifying incentive targets for corporate compliance, define the criteria for their identification, and improve the process of identifying such targets. By maximizing the incentive effects of corporate compliance, we can promote the steady development of compliance reform in our country.

A Pilot Trial of a Home-Based Parenting Intervention for High-Risk Infants: Effects on and Moderating Role of Effortful Control

Despite the important developmental outcomes associated with effortful control (EC), there is limited research demonstrating the efficacy of early interventions for improving EC and assessing the extent to which a child’s level of baseline EC impacts the outcome of intervention on externalizing problems. This study aims to fill these gaps in the literature by assessing the efficacy of the Infant Behavior Program (IBP), a parenting intervention for infants with elevated levels of behavior problems, in improving infant EC and the moderating effect of baseline infant EC on intervention outcomes. Participants included 60 high-risk 12- to 15-month-old infants and their mothers. Families were randomized to receive the IBP or standard pediatric primary care. Parent-report measures of infant behavior and compliance were examined at baseline, post-intervention, and 3- and 6-month follow-up assessments. Results showed infants who received the IBP displayed significantly higher levels of EC at the post-intervention assessment compared to infants in the control group. Additionally, moderation analyses showed initial levels of EC moderated the effect of the IBP on externalizing problems and compliance, such that infants with higher levels of baseline EC displayed greater decreases in externalizing problems at post-intervention and greater increases in compliance at the 6-month follow-up. While these findings did not survive a false discovery rate correction, they offer preliminary support for the efficacy of the IBP in improving infants’ EC and highlight the importance of considering EC as a factor associated with early intervention outcomes for externalizing problems.

Compliance Risk Assessment in the Banking Sector: Application of a Novel Pairwise Comparison-Based PRISM Method

Up-to-date compliance management uses a risk-based approach based on international standards. In addition to techniques and practices, implementing compliance measures is determined by principles and culture. Compliance risk assessment is an evolving field in theory and practice. Compliance risk management is complex and highly dependent on the decisions of experts. This article presents a new compliance risk assessment method based on a commercial banking case study. In the study, the Guilford method is used to extend the Partial Risk Map (PRISM) assessment technique, and the steps of the proposed pairwise comparison-based PRISM method are described in detail. Since risk assessment is critical to the operation and development of compliance management systems, the proposed risk assessment method involves testing individual evaluations’ consistency and the results’ robustness. The best-fitting and outlier experts can be identified based on testing the impact of individual expert rankings on the aggregated ranking. The main finding is that top partial risks can be identified by applying the proposed pairwise comparison-based PRISM technique; therefore, possible optimal risk mitigation strategies and measures can be designed.

Association of forced oscillation technique measurements with respiratory system compliance and resistance in a 2-compartment physical model

BackgroundThe forced oscillation technique (FOT) may be useful for diagnosis and follow-up of respiratory diseases. It is unclear how global or regional alterations in airway resistance (Raw) and lung compliance (CL) alter FOT measurements. MethodsA 2-compartment physical model of the respiratory system allowed to simulate variations in Raw, CL, and their heterogeneity during tidal breathing in an adult human. Five-Hz respiratory system resistance (Rrs5) and reactance (Xrs5), area of reactance (AX), resonance frequency (Fresp) and intrabreath variation in Rrs5 and Xrs5 were measured by FOT. Frequency dependance of resistance could not be studied in this model. Relationships between model characteristics (Raw, CL, and heterogeneity) and FOT measurements were explored by multiple regression. ResultsRrs5 and intrabreath variation in Rrs5 and Xrs5 strongly associated with model characteristics (R2=0.753, 0.5 and 0.658). Associations of Xrs5, AX, and Fresp with model characteristics were weak (R2=0.214, 0.349 and 0.076). Raw heterogeneity was the main determinant of Rrs5 (Coeff=0.594), AX (Coeff=0.566) and intrabreath variation in Rrs5 and Xrs5 (Coeff=0.586 and 0.732). Regional extremes in Raw strongly determined Rrs5 (Coeff=1.006). Xrs5 did not strongly associate with any model characteristic. ConclusionRaw heterogeneity and maximal regional Raw were the main determinants of FOT measurements, in particular Rrs5. Associations between CL and FOT measurements were weak.

Carceral safety in a post-PREA era: An examination of perceptual indicators of safety among incarcerated persons in four southeast prisons

Since the inception of the 2003 Prison Rape Elimination Act (PREA), its reception has been notably ambivalent among practitioners and scholars. While this policy was promoted as a means of enhancing safety in carceral facilities, some view it as a superfluous inconvenience. Unfortunately, the intended beneficiaries of PREA have been largely excluded from this discourse. The current study addresses this gaping oversight by examining perceptual predictors of safety among those housed across four prisons in a southeastern state. Using survey data collected from more than 1500 incarcerated men, this study examines the relationship between self-reported safety indicators and a variety of policy compliance proxies, facility resource measures, interpersonal relationships between staff and inmates, and other relevant themes. The results of this study reveal that some measures of PREA compliance, specifically investigation efficiency and knowledge of the reporting process, are positively related to the respondent's sense of safety from inmate violence as well as safety from staff violence. Prison resources, staff interactions, exposure to violence, and other notable predictors are also significantly related to safety perceptions. These findings underscore the importance of the quality of PREA implementation in conjunction with resource sufficiency and constructive interactions with staff.

The impact of coal mine dust characteristics on pathways to respiratory harm: investigating the pneumoconiotic potency of coals.

Exposure to dust from the mining environment has historically resulted in epidemic levels of mortality and morbidity from pneumoconiotic diseases such as silicosis, coal workers' pneumoconiosis (CWP), and asbestosis. Studies have shown that CWP remains a critical issue at collieries across the globe, with some countries facing resurgent patterns of the disease and additional pathologies from long-term exposure. Compliance measures to reduce dust exposure rely primarily on the assumption that all "fine" particles are equally toxic irrespective of source or chemical composition. For several ore types, but more specifically coal, such an assumption is not practical due to the complex and highly variable nature of the material. Additionally, several studies have identified possible mechanisms of pathogenesis from the minerals and deleterious metals in coal. The purpose of this review was to provide a reassessment of the perspectives and strategies used to evaluate the pneumoconiotic potency of coal mine dust. Emphasis is on the physicochemical characteristics of coal mine dust such as mineralogy/mineral chemistry, particle shape, size, specific surface area, and free surface area-all of which have been highlighted as contributing factors to the expression of pro-inflammatory responses in the lung. The review also highlights the potential opportunity for more holistic risk characterisation strategies for coal mine dust, which consider the mineralogical and physicochemical aspects of the dust as variables relevant to the current proposed mechanisms for CWP pathogenesis.

Effect of walnut consumption on neuropsychological development in healthy adolescents: a multi-school randomised controlled trial

Omega-3 fatty acids are critical for neuropsychological functioning. Adolescence is increasingly believed to entail brain vulnerability to dietary intake. The potential benefit on adolescent neurodevelopment of consuming walnuts, a source of omega-3 alpha-linolenic acid (ALA), remains unclear. We conducted a 6-month multi-school-based randomised controlled nutrition intervention trial to assess whether walnut consumption has beneficial effects on the neuropsychological and behavioural development of adolescents. The study took place between 04/01/2016 and 06/30/2017 in twelve different high schools in Barcelona, Spain (ClinicalTrials.gov Identifier: NCT02590848). A total of 771 healthy teenagers aged 11-16 years were randomised into two equal groups (intervention or control). The intervention group received 30g/day of raw walnut kernels to be incorporated into their diet for 6 months. Multiple primary endpoints concerning neuropsychological (working memory, attention, fluid intelligence, and executive function) and behavioural (socio-emotional and attention deficit hyperactivity disorder [ADHD] symptoms) development were assessed at baseline and after intervention. Red blood cell (RBC) ALA status was determined at baseline and 6 months as a measure of compliance. Main analyses were based on intention-to-treat using a linear mixed-effects model. A per-protocol effect of the intervention was analysed using inverse-probability weighting to account for post-randomisation prognostic factors (including adherence) using generalised estimating equations. In intention-to-treat analyses, at 6 months there were no statistically significant changes between the intervention and control groups for all primary endpoints. RBC ALA (%) significantly increased only in the intervention group, coefficient=0.04 (95% Confidence Interval (CI)=0.03, 0.06; p<0.0001). The per-protocol (adherence-adjusted) effect on improvement in attention score (hit reaction time variability) was-11.26ms (95% CI=-19.92,-2.60; p=0.011) for the intervention group as compared to the control group, improvement in fluid intelligence score was 1.78 (95% CI=0.90, 2.67; p<0.0001), and reduction of ADHD symptom score was-2.18 (95% CI=-3.70,-0.67; p=0.0050). Our study suggested that being prescribed eating walnuts for 6 months did not improve the neuropsychological function of healthy adolescents. However, improved sustained attention, fluid intelligence, and ADHD symptoms were observed in participants who better complied with the walnut intervention. This study provides a foundation for further clinical and epidemiological research on the effect of walnuts and ALA on neurodevelopment in adolescents. This study was supported by Instituto de Salud Carlos III through the projects 'CP14/00108, PI16/00261, PI21/00266' (co-funded by European Union Regional Development Fund 'A way to make Europe'). The California Walnut Commission (CWC) has given support by supplying the walnuts for free for the Walnuts Smart Snack Dietary Intervention Trial.