Degree Of Compliance Research Articles

Political orientation and adherence to social distancing during the COVID-19 pandemic in Italy

Many governments have implemented social distancing and lockdown measures to curb the spread of the novel coronavirus (COVID-19). Using province-level geolocation data from Italy, we document that political disbelief can limit government policy effectiveness. Residents in provinces leaning towards extreme right-wing parties show lower rates of compliance with social distancing order. We also find that, during the Italian lockdown, provinces with high protest votes virtually disregarded all social distancing orders. On the contrary, in provinces with higher political support for the current political legislation, we found a higher degree of social distancing compliance. These results are robust to controlling for other factors, including time, geography, local COVID-19 cases and deaths, healthcare hospital beds, and other sociodemographic and economic characteristics. Our research shows that bipartisan support and national responsibility are essential to implement and manage social distancing efficiently. From a broader perspective, our findings suggest that partisan politics and discontent with the political class (i.e., protest voting) might significantly affect human health and the economy.

Patient Acceptance of Routine Serial Postoperative Endoscopy Following Low Anterior Resection (LAR) and Its Ability to Detect Biomarkers in Anastomotic Lavage Fluid.

Various reports have now established that postoperative endoscopy to examine and intervene in the process of anastomotic healing is both feasible and safe. Here we present our preliminary experience with serial postoperative endoscopy to determine its feasibility, patient acceptance and the ability to obtain and the utility of perianastomotic material for molecular analysis. Patients undergoing LAR with ileostomy for rectal cancer were recruited for study to undergo routine serial endoscopic surveillance (SES) at three time points during the course of LAR: intraoperatively, before discharge (postoperative day 3-7) and at follow-up (postoperative day 10-28). At each endoscopy, images were captured, anastomotic tissues were lavaged and lavage fluid was retrieved. Fluid samples were analyzed using proteomics, zymography, ELISA and bacteria via 16S rRNA gene amplicon sequencing and culture of collagenolytic strains. SES is feasible and acceptable to this limited set of patients following LAR. Biologic analysis of perianastomotic fluids was able to detect the presence of proteins, microbiota and inflammatory mediators previously identified at anastomotic sites in animals with pathologic healing. SES can be implemented in patients undergoing LAR with a high degree of patient compliance and capture of biologic information and imaging. Application of this approach has the potential to uncover, for the first time, the natural history of normal versus pathologic anastomotic healing in patients undergoing anastomotic surgery.

Assessing transparency in fisheries subsidies: A notification-driven analysis

The availability of fisheries subsidies data has been a challenge since the beginning of WTO negotiations, with government disclosure being historically low. No multilateral agency is currently mandated to systematically collect, assemble and disseminate fisheries subsidies data and the knowledge base remains weak. While anecdotal evidence is abundant, subsidy notifications have not been systematically explored as a source of policy intelligence. By proposing a novel approach to extract and analyze information from WTO notifications, this paper aims to fill this gap and shed new light upon the ultimate determinants of government transparency in relation to fisheries subsidies. By screening texts of notifications by China and the United States under the Agreement on Subsidies and Countervailing Measures (SCM) (1995–2016), this paper identifies a unique set of 61 fisheries and aquaculture policies. For each, budget allocations or expenditures are extracted, and qualitative policy information categorized. This is then used to measure the degree of compliance with notification requirements (SCM Agreement, Art. 25.3). This paper argues that, while government transparency plays a role in determining the level and quality of notified information, intrinsic characteristics of the notification framework may also work as hindrances to sound reporting. A comprehensive effort that simultaneously involves the content, institutional and technological dimensions is needed in order to modernize the WTO notification framework in a way that creates new and better incentives for disclosure.

The Legal Aspect of Fingering Mother Cap in the Making of Land & Buying Deals

The research objective is to unto know and analyze application Affixing the thumbprint in making land sale and purchase deeds, unto know and analyze legal consequences of affixing a thumbprint in the making of a land sale and purchase deed, and untuk know and analyze the extent of the function Affixing the thumb print in the making of the land sale and purchase deed. This research is a qualitative research with a normative juridical approach.This research was conducted in Kendal Regency. Based on the results of research and discussion it can be seen that " The application of the thumbprint affixing in making the sale and purchase deed of the tappers in minuta by the notary / PPAT is to identify the presence of the tappers. Proof of presence that the person who comes to the Notary / PPAT is the person concerned who wants to make a Notary / PPAT Deed, not someone else. The thumbprint affixing has legal consequences in the making of the Land Sale and Purchase Deed because it has benefits before the signing of the deed by the notary so that the notary still has the opportunity to correct previously unseen mistakes. One of the purposes of affixing the thumbprint before signing the deed is that It is a guarantee for the parties that the signed deed is the same as what has been read, and the deed is read so that the parties can be certain that the writing or content of the deed is true to the wishes of the tappers. The function in the application of affixing a thumbprint in making deeds is to identify the presence of tappers. Proof of presence that the person who came to the Notary / PPAT was the person concerned who wanted to make a Notary / PPAT Deed, not someone else. The obligation to attach the tappers' fingerprints to the Minuta Deed of Notary / PPAT aims to anticipate if one day the tappers deny their signature on the Minuta Deed of Notary / PPAT, then as additional evidence used the tapping's fingerprint. Suggestions were submitted for compliance and legal awareness from the community Affixing the thumbprint in the making of the land sale and purchase deedIt must be improved, among others, through legal counseling, distribution of pamphlets related to land law issues in a communicative language so that it can be understood by the general public, or through other reading materials, and also through the mass media so that through various methods it is expected people who were previously blind to the law can know and understand the law. And if you already know and understand the law, then this will be able to increase the degree of compliance and legal awareness of the community in the field of land law.

Security Evaluation for Stream Cipher Cryptosystem Based on Soft Computing and Theoretic Parameters

Security evaluation means an examination of a system to determine its degree of compliance with a stated security model, security standard, or specification. There are different models for security assessment, and the operation of selecting the appropriate model depends on the type of the cryptosystem. Consequently, the criteria for assessing security differ from one model to another. Information security contributes directly to increase the level of trust between users by providing an assurance of confidentiality, integrity, and availability. The main goal of this paper proposing an evaluation model of the cryptography systems. in this paper focuses the stream cipher started from its simple component LFSR and then add more than one register and using a linear feedback shift register (LFSR) with Langford arrangements to generate system to achieve randomness and complexity and evaluated based on statistical tests, information theory, soft computing (fuzzy logic), game theory. The results were acceptable and successfully passed the required tests.

Evaluation of the balance of oils from fish by-products

Fish by-products is a promising raw material for fish oil extraction, which is a source of polyunsaturated fatty acids, including omega-3 and omega-6 classes. Gas chromatography method was used to study the fatty acid composition of oils extracted from six types of fish by-products including heads, ridges and internal organs of Atlantic mackerel, Baltic herring, fresh Baltic sprat, heads and ridges of Atlantic salmon and heads of fresh herring and smoked sprat. The highest content of omega-3 polyunsaturated fatty acids was found in mackerel and herring processing by-products – 43.6 and 49.6 %, respectively. The coefficients of oil balance are calculated. The coefficient of rationality of the fatty acid composition, which reflects the degree of compliance of oil with the “ideal” lipid for human nutrition was the highest for sprat oil (0.87 units fraction). Sprat oil is characterized by the most favorable ratio of saturated and polyunsaturated fatty acids, since the coefficient of biological efficiency is as close as possible to 1. The coefficients of rationality of the fatty acid composition of other oils are reduced due to the significant predominance of omega-3 fatty acids. It is promising to use the studied oils to optimize the fatty acid composition of products based on animal fats and vegetable oils, which are characterized by a high content of omega-6 fatty acids.

Disturbance of compliance in patients with paranoid schizophrenia in the process of neuroleptic treatment

As the development of approaches to correct compliance disorders in patients with schizophrenia remains relevant today, we examined 112 patients and studied both clinical and psychopathological and pathopsychological features on the background of treatment with neuroleptics. To identify and evaluate clinical and psychological characteristics of patients with varying degrees of adherence to treatment with neuroleptics. For implementation of the objectives of the work both clinical and psychological and psychodiagnostic examination of the mnestic and emotional sphere, personal characteristics and self-esteem in patients were used.The use of the scale of drug compliance gave the opportunity to single out groups of patients with varying degrees of compliance. The application of the technique to study the side effects of antipsychotics revealed a relation between severity of side effects of medications and patients’ compliance. Along with psychopathological features, the group with noncompliance was characterized by the maximum severity of disorders in cognitive sphere. Medical treatment was accompanied with changes in emotional sphere in the form of objective signs of affective discomfort, least pronounced in patients with full compliance. The personal features differing in patients with varying degrees of adherence to treatment were established. Analysis of color associations based on color test relationships with emotionally significant individuals and concepts revealed the most pessimistic associations with negative values of colors in relation to health and disease in patients with noncompliance. Self-assessment of patients with noncompliance was characterized by the lowest rates in contrast to patients with partial and full compliance. The revealed psychodiagnostic features make up pathopsychological complexes of symptoms, which serve as differential diagnostic criteria of compliance of varying degrees.

Study of the socio-economic living conditions of the rural population of the Krasnoyarsk Territory

This article examines the socio-economic sphere of life of the rural population at the level of the region and individual municipal districts. The aim of the work was to obtain objective assessments of the level of social and economic well-being of the rural population and determine the list of infrastructure facilities, the introduction of which will lead to an improvement in living conditions in rural areas. The object of the study was the rural areas of the Krasnoyarsk Territory and the quality of life of rural households. The research methodology was based on the use of the index method for aggregating data characterizing various aspects of the social well-being of a rural resident. As a result of the study, it was found that most of the rural population of the region under consideration lives in conditions that are significantly different from living in an urban environment. The disproportions in the level of income, housing improvement, the availability of social engineering infrastructure, and the availability of basic social services are highlighted. About 63% of rural residents do not have access to centralized water supply, heat supply and sewerage systems. The problem of wear and tear of fixed assets in healthcare, education, and transport infrastructure is critical. The highest degree of compliance of rural living conditions with urban standards of social comfort is observed in the regions of the Far North, which have a special legal status and industrial specialization of the territorial economy. Rural territories with a predominantly agrarian type of economy cannot provide the necessary volume of investment in fixed assets, mass employment and an acceptable level of income for rural households.

A Comparative Analysis of Macroprudential Policy across Euro Area Candidate Countries

Concerns to setting an appropriate overall macroprudential policy framework have taken shape at local, regional, and global level since the onset of the global financial crisis. At regional level, a particular case is that of the European Union, given the national-supranational relationship specific to this economic region. The article aims to identify the macroprudential policy condition of the Euro Area candidate countries, by using an index built on some criteria that describe on the one hand, the capacity of macroprudential policy governance and the “activism” of macroprudential authority, and, on the other hand, the degree of compliance with the European Systemic Risk Board (ESRB) recommendations for national macroprudential authorities, given that the countries under review are member states of the European Union. Our findings show that the Euro Area candidate countries have quite different macroprudential policy features, both in terms of its governance and in terms of the “convergence” towards ESRB recommendations. Although the analysis should be extended by adding other relevant criteria, we can assert that it offers an overview of the potential role of the national macroprudential policy as a shock-absorber instrument in the perspective of a future accession to the Euro Area.

ЕКОНОМІЧНА ЕФЕКТИВНІСТЬ ПРАВОВИХ НОРМ ТА ЇЇ ОЦІНКА ЧЕРЕЗ ПРИЗМУ ПРИНЦИПУ ВЕРХОВЕНСТВА ПРАВА (НА ПРИКЛАДІ ПОДАТКОВОГО ЗАКОНОДАВСТВА)

Відзначено, що важливою якістю правового регулювання має виступати ефективність обраних державою методу і засобу сприяння досягненню запланованого соціально-економічного результату. Попри те що на законодавчому рівні вияв дістали окремі засади нормопроєктної роботи (зокрема, на прикладі законодавства у сфері регуляторної політики), триває практика ухвалення нормативно-правових актів, ефективність яких залишається сумнівною. Однією з причин такого стану правового регулювання суспільних відносин можна назвати неналежне врахування, а часом свідоме ігнорування теоретико-прикладних конструкцій, що були обґрунтовані в межах правової та економічної науки. У підсумку це призводить до утвердження в певній сфері суспільних відносин несправедливого порядку, що ставить під загрозу подальший сталий розвиток держави.З огляду на це, увагу сконцентровано на дефектах втілення правових принципів, передусім принципу верховенства права, у сферу правового регулювання економічних відносин, що спричиняє виникнення уявної ефективності відповідних правових актів. Доведено, що про ефективність правового регулювання суспільних відносин свідчитиме не тільки показник досягнення правовою нормою очікуваного результату за рахунок мінімально необхідних витрат ресурсів суб’єктів господарювання, громадян і держави (тобто економічний критерій), але й ступінь відповідності такої правової норми принципу верховенства права, що дозволить говорити про сприяння утвердженню правовим актом ідеології справедливості. На основі аналізу окремих прикладів із законотворчої практики у сфері оподаткування встановлено, що прийняття нормативно-правових актів усупереч принципу верховенства права призвело до спрямування податкової політики на досягнення соціально-економічних результатів, які суперечать принципам податкової політики як виду економічної політики і засадам соціальної політики держави у частині перерозподілу доходів, викладеним у документах стратегічного характеру.

Automatic Assessment of Privacy Policies under the GDPR

To comply with the EU General Data Protection Regulation (GDPR), companies managing personal data have been forced to review their privacy policies. However, privacy policies will not solve any problems as long as users do not read or are not able to understand them. In order to assist users in both issues, we present a system that automatically assesses privacy policies. Our proposal quantifies the degree of policy compliance with respect to the data protection goals stated by the GPDR and presents clear and intuitive privacy scores to the user. In this way, users will become immediately aware of the risks associated with the services and their severity; this will empower them to take informed decisions when accepting (or not) the terms of a service. We leverage manual annotations and machine learning to train a model that automatically tags privacy policies according to their compliance (or not) with the data protection goals of the GDPR. In contrast with related works, we define clear annotation criteria consistent with the GDPR, and this enables us not only to provide aggregated scores, but also fine-grained ratings that help to understand the reasons of the assessment. The latter is aligned with the concept of explainable artificial intelligence. We have applied our method to the policies of 10 well-known internet services. Our scores are sound and consistent with the results reported in related works.

Maternal awareness to the timing of allergenic food introduction in Saudi infants: A cross-sectional study.

BackgroundCurrent guidelines recommend the introduction of allergenic foods as early as 4–6 months of age to decrease the risk of food allergy. However, caregivers’ knowledge about such practices and adherence to them is ambiguous.ObjectivesThe purpose of this study was to evaluate the timing of introduction of potentially allergenic foods into children’s diet and the level of maternal awareness about and degree of compliance with current recommendations.Materials and methodsWe conducted a cross-sectional study from May 2019 to January 2020 at Imam Mohammad Ibn Saud Islamic University Medical Center, Riyadh, Saudi Arabia. Data were collected through questionnaire-based surveys, and a total of 405 mothers were enrolled in the study. The eligibility criteria included mothers of children between the ages of 12 and 36 months.ResultsMost mothers in this study had initiated allergenic foods, and the average time of introduction was 9.84 ± 3.16 months for eggs, 14.6 ± 5.78 months for peanuts, and 13.6 ± 5.37 months for fish. Around one-quarter (n = 102, 25.2%) of the children were identified as being in the high-risk group. Most mothers did not know or disagreed that the timing of introducing allergenic foods might help in preventing food allergy, but there was no difference between the risk groups (33.8% and 26.2%, respectively). Moreover, only 18.6% and 13.2% of the high- and low-risk groups, respectively, received correct information from their health care providers (P = .004). Mothers with only one child were less likely to start eggs at an early age (odds ratio [OR] = 0.5 and P = .005). Furthermore, children at a high risk of food allergy were two times more likely to start eggs at an earlier age (OR = 2.12 and P = .003).ConclusionIn this study, the allergenic food feeding practices being followed for infants and young children were found to be suboptimal. Parental education level and the number of siblings were identified as potential barriers to the implementation of and adherence to recent guidelines. There is a need for corrective measures to ensure safe and appropriate feeding practices in the Saudi community.

Mobile bricklaying robot as a breakthrough technology in construction: advantages and problems

The article discusses the concept of “breakthrough technologies” and its criteria in relation to a bricklaying robotic system. In order to become a breakthrough, a new technology must be able to deeply integrate into the relevant industry. This requires the fulfillment of a number of criteria, both technical and beyond. Therefore, a number of such criteria have been formulated for a mobile robotic bricklaying system to assess the degree of compliance with industry requirements and readiness to become a breakthrough innovation. Also the systemic problems hindering the implementation of the technology in the construction industry are considered. The developed approach can also be used for other technical systems and complexes that require significant development costs and at the same time offer some innovative approaches to solving the problems in their fields.

A methodological approach formation to assessing the compliance degree with the requirements and the achieving it cost at the product life cycle stages

Currently, industrial enterprises and operating organizations is in the development process and the products’ system life-cycle management formation. In this system, the compliance assessment and cost analysis on product quality are the main objectives. Under ISO 9000 series standards, product cost assessment is one of the enterprise quality management system basic elements. To do this, product quality costs must be set, processed and analysed in the same way as other costs. At the moment, there are different approaches to determining the quality products cost that is not effective enough. The presented work has developed a methodical approach that can be applied in assessing the products’ life cycle total cost and determining the “price-quality” effectiveness type.

Knowledge and Compliance Regarding Standard Precautions among Nursing Students at Universiti Sains Malaysia

Background: Standard precautions (SP) are important in protecting both patients and healthcare professionals from occupational exposure as well as ensure patient safety. This study aimed to compare the knowledge and compliance regarding SP among diploma and degree nursing students at Universiti Sains Malaysia (USM). Methods: A cross-sectional study has been conducted among 134 nursing students using self-administered questionnaires. Respondents were recruited using a simple random sampling method. The data were analyzed by SPSS version 24 using descriptive and Spearman’s Rank-Order test. Results: The study showed that diploma and degree nursing students had good knowledge regarding SP (mean of 14.7±2.5 and 15.4 ± 2.4) and a high compliance level of SP (mean of 3.6 ± 0.3 and 3.7 ± 0.2 respectively). Washes hand immediately after contacting any blood, body fluid, secretion, excretion, and dirty substances has the highest degree of compliance among diploma nursing students, while washes hands when comes in different contact with different patients has the highest degree of compliance among bachelor degree nursing. Wear protective eye patch or google when performing operations/procedures that might induce spraying of blood, body fluids, secretions, and excretions was the lowest degree of compliance among both bachelor degree and diploma nursing students. There was no significant correlation between the level of knowledge and compliance with SP (p= 0.23) but there is a significant correlation between the duration of practical training and compliance with SP (p=0.02). Conclusion: Nursing students in USM had good knowledge and high compliance regarding SP. Knowledge did not influence compliance with SP but duration of practical training session did influence compliance with SP.

Public health matters: why is Latin America struggling in addressing the pandemic?

This article examines how Argentina, Brazil, Chile, Colombia, Mexico, and Peru addressed the COVID-19 pandemic and the effectiveness of these policy responses from the date each country declared a sanitary emergency, between middle and late March 2020 to the most recent available measurement on 23 September 2020. To analyze how governments responded to the COVID-19 pandemic in these six Latin American countries, we use an index of government response, created by the University of Oxford. To explore the effects of these governmental mitigation policies on reducing social mobility, we use Google mobility reports. We also analyze how these policies may have influenced COVID-19 mortality rates. Overall, the results showed that both timelier and more stringent implementation of the public policies analyzed to address the COVID-19 pandemic seem to be associated with higher mobility reductions and lower mortality rates. We draw five policy lessons from the way each country implemented these mitigation policies.Key message Timelier and more stringent implementation of these public policies may contribute to a higher mobility reduction in several public spaces and to lower mortality rates.The effectiveness of the closure and containment policies in each Latin American country seem to depend on the degree of compliance of their respective populations and to their socioeconomic living conditions.Economic and social policies of income support and debt relief provided by governments allowed people to comply with closure and containment policies.Health systems should maintain high levels of policy stringency together with effective surveillance through testing policy and contact tracing. Supplementary informationThe online version of this article (10.1057/s41271-020-00269-4) contains supplementary material, which is available to authorized users.

An Empirical Analysis of COVID-19 Response: Comparison of US with the G7

We compare US policy response to COVID-19 with its G7 counterparts between March and September 2020. The G7 countries, while economically and ideologically aligned, have instituted vastly different policies to mitigate the spread of the disease with varying degrees of compliance. To quantify the effect of policy responses on the spread of infections, we estimate beta for each country which is the slope coefficient of daily new cases in each country regressed against world new cases. First we test for structural breaks in daily data for world new cases using the Bai Perron (1998, 2003a, 2003b) method which endogenously determines break points. We obtain five break dates that allow us to divide the time period into six windows and estimate betas separately for each window. Next we rank the G7 countries based on their beta values for each window. Our empirical findings suggest that countries that eased their lockdown measures moderately while enforcing nationwide mask mandate and comprehensive contact tracing generally performed better in mitigating the spread of new infections. Furthermore, countries with higher degree of compliance saw improvement in their rankings. US was ranked mostly in the bottom half of the G7 group but not always the worst.

Noble Metal Nanomaterials for NIR-Triggered Photothermal Therapy in Cancer.

It is of great significance to develop anticancer therapeutic agents or technologies with high degree of specificity and patient compliance, while low toxicity. The emerging photothermal therapy (PTT) has become a new and powerful therapeutic technology due to its noninvasiveness, high specificity, low side effects to normal tissues and strong anticancer efficacy. Noble metal nanomaterials possess strong surface plasmon resonance (SPR) effect and synthetic tunability, which make them facile and effective PTT agents with superior optical and photothermal characteristics, such as high absorption cross-section, incomparable optical-thermal conversion efficiency in the near infrared (NIR) region, as well as the potential of bioimaging. By incorporating with various functional reagents such as antibodies, peptides, biocompatible polymers, chemo-drug and immune factors, noble metal nanomaterials have presented strong potential in multifunctional cancer therapy. Herein, the recent development regarding the application of noble metal nanomaterials for NIR-triggered PTT in cancer treatment is summarized. A variety of studies with good therapeutic effects against cancer from impressive photothermal efficacy of noble metal nanomaterials are concluded. Intelligent nanoplatforms through ingenious fabrication showing potential of multifunctional PTT, combined with chemo-therapy, immunotherapy, photodynamic therapy (PDT), as well as simultaneous imaging modality are also demonstrated.

Exposome changes in primary school children following the wide population non-pharmacological interventions implemented due to COVID-19 in Cyprus: A national survey.

BackgroundNon-pharmacological interventions (NPI), including lockdowns, have been used to address the COVID-19 pandemic. We describe changes in the environment and lifestyle of school children in Cyprus before the lockdown and during school re-opening, and assess compliance to NPI, using the exposome concept.MethodsDuring June 2020, parents completed an online questionnaire about their children's lifestyle/behaviours for two periods; school re-opening (May 21-June 26) following the population-wide lockdown, and the school period before lockdown (before March).FindingsResponses were received for 1509 children from over 180 primary schools. More than 72% of children complied with most NPI measures; however, only 48% decreased the number of vulnerable contacts at home. Sugary food consumption was higher in the post-lockdown period with 37% and 26% of the children eating sugary items daily and 4–6 times/week, compared to 33% and 19%, respectively, for the pre-lockdown period (p<0.001). Children's physical activity decreased compared to pre-lockdown (p<0.001), while screen time increased in the post-lockdown period, with 25% of children spending 4-7 hours/day in front of screens vs. 10% in the pre-lockdown period (p<0.001). About half of the children washed their hands with soap 4–7 times/day post-lockdown vs. 30% in the pre-lockdown period (p<0.001).InterpretationThis national survey showed a high degree of compliance to NPI measures among school children. Furthermore, the exposome profile of children may be affected in the months following NPI measures due to alterations in diet, physical activity, sedentary behaviour, and hand hygiene habits.FundingPartial funding by the EXPOSOGAS project, H2020 Research and Innovation Programme (grant #810995).

DEMOGRAPHICS AND MAJOR INDICATIONS FOR THE WARFARIN USE, THE COMPLIANCE RATE AND THE FACTORS CONTRIBUTING IN NON-ADHERENCE AMONG PATIENTS PRESENTING TO A TERTIARY CARDIAC CENTER OF PAKISTAN

Objective: To assess the impact of a dedicated hospital based warfarin clinic assessing patients’ knowledge and improving the drug compliance in a tertiary cardiac center of Pakistan.&#x0D; Study Design: Descriptive cross sectional study.&#x0D; Place and Duration of Study: Rawalpindi Institute of Cardiology from Jan 2019 to Jul 2019.&#x0D; Methodology: Patients presenting in the anticoagulation clinic using warfarin for different cardiovascular indications from Jan to Jul 2019 were included in the study. Patients were assessed for their underlying cardiovascular condition, their international normalized ratio levels checked using a standard technique. The patients’ knowledge about the drug and the degree of compliance was judged by eight-item Morisky Medication Adherence Scale (MMAS-8). The patients were thoroughly counseled and reassessed six months later assessing the improvement in compliance with the warfarin therapy.&#x0D; Results: Total number of 401 patients using warfarin for different cardiovascular diseases were studied. The mean age was 43.3 ± 13.3 years with 218 (54.5%) patients being male. Most of the patient 300 (75%) belonged to the low socio-economic group with average monthly income of &lt;PKR 10,000/$65. In addition, 61.4% of the patients belonged to the rural set up. Mechanical valve replacement made the bulk of the indication for warfarin therapy with 44.7% of patients with mechanical mitral valve, 14% with mechanical double valve and 13% with mechanical aortic valve replacement. 13.7% of the patients on warfarin therapy had atrial fibrillation while 6.9% either had venous thromboembolism and pulmonary embolism. The compliance was good in 76.1% on baseline visit which increased to 86.7% on the first visit at six-month interval. Residence in rural areas and low socioeconomic status were the two factors contributing to poorer compliance which improved on the first visit.&#x0D; Conclusion: Low socioeconomic status and residents of rural areas were resulting in comparatively poorer compliance with warfarin therapy which improved by educating such patients in specific warfarin clinic.