Degree Of Compliance Research Articles

DEVELOPMENT OF A SYSTEMATIC APPROACH TO ASSESSING THE COMPLIANCE OF UNIVERSITY EDUCATIONAL PROGRAMS WITH THE UN SUSTAINABLE DEVELOPMENT GOALS

The purpose of the article is to develop and test in practice a systematic approach to assessing the compliance of educational programs of universities with the goals of sustainable development of the United Nations. The systematic approach includes the development of a sequence of development and approval of a questionnaire to determine the degree of compliance of educational programs of universities with the goals of sustainable development. Methodology. The survey was based on a comparison of the data of three groups of respondents (developers of educational programs and their curators at three levels of higher education). Approbation of the approach took place on the basis of the National Transport University (Kyiv, Ukraine). In total, 64 curators and developers of educational programs took part in the survey (this is 60% of educational programs of NTU). The results of the survey showed that educational program developers understand the importance of including the tasks of the United Nations Development Program in separate educational components or modules of disciplines in order to form relevant competencies in students. However, respondents noted the need to review educational programs and their components, as well as the educational process in the context of compliance with the goals of sustainable development and its ecologization. Practical implications. The results of this research will be used during the regular review of educational programs and their components at the National Transport University, and will also serve as a basis for further improvement of the concept of sustainable development of the NTU. The research data can be distributed to other universities. Also, the research results will be used in the project the Transformational Learning Network for Resilience – Enabling Ukrainian higher education to ensure a sustainable and robust reconstruction of (post-war) Ukraine (TransLearnN). The results of this study will contribute to the development of the program of sustainable development of universities in Ukraine. Value / Originality. The obtained results will make it possible to determine prospective directions for improving the educational process and educational programs of universities, taking into account the goals of sustainable development and trends in the ecologization of education.

Evaluating compliance with track and trace and other regulations in Pakistan's cigarette market.

To control the illicit cigarette market, the government of Pakistan adopted a Tracking and Tracing System (TTS) that was fully operational by July 2022, despite many roadblocks. By this date, major tobacco companies had either registered their brands with the tax authority and/or installed TTS. This paper is the first to evaluate the degree of compliance with the TTS by evaluating the extent and nature of illicit trade in tobacco products. We use randomised sampling to collect cigarette packs from waste recycling stores located in the ten most populous cities of Pakistan, to evaluate illicit trade penetration. Almost a third of the packs collected did not bear a tax stamp, mostly due to the lack of compliance by local companies, confirming a recent review of the TTS implementation by the Federal Bureau of Revenue (FBR). Even the largest companies that ostensibly adopted the TTS did not fully comply with the system, signalling poor enforcement. This is a missed opportunity, since a well-functioning TTS combined with proper enforcement is an effective means of controlling illicit tobacco trade, boosting tax revenue and improving public health. However, the enforcement should not be limited to the TTS since 23.6% of packs did not comply with other regulatory requirements.

Development of a tool to assess the compliance of canteen menus with the Mediterranean Diet

Abstract The Mediterranean Diet (MD) is one of the healthiest food patterns associated with important health benefits. Acknowledging this, it’s important to understand how the dietary patterns of the consumers align with the MD. Over time, different authors have formulated several indexes for this purpose. However, current indexes lack standardization, and they only evaluate the quality of the diet of individuals to be used by health professionals and political decision-makers. Although there are indexes to assess the food options at the restaurants, none of them assess the menu compliance with the MD. Due to the importance of the food services in the food choices and dietary patterns of the consumers, this research developed an index to assess the alignment of the food availability with the MD key points. To address this gap, after reviewing the existing indexes in the literature, the authors created a tool that assesses the degree of compliance of menus with the MD - MedCIn. This index is divided into 4 dimensions, the first one assesses the availability (part A) and variety (part B) of the food/food groups. The second dimension assesses the nutritional quality of the menus based on the nutritional declaration, the third dimension assesses the food portions and culinary options, and the fourth dimension allows the verification of the previous information on site. Although the use of all dimensions allows for a more comprehensive menu evaluation, dimension one can be used as a first approach MD compliance. The index is meant to be applied in a 4-week cycle, though it can be adapted for each food service. Validation of this tool included construct validity, internal consistency and inter-rater reliability, all of which returned high values (alpha-Cronbach=0.88; Coheńs Kappa=0.92). The researchers consider this a reliable tool to easily assess compliance of menus with MD key points, allowing for the identification of issues to be addressed and improved

Environmental and economic dynamics of the Galician fishing sector and compared perceptions of the agents involved in the value chain

ABSTRACT This case study analyses and compares the perceptions of agents that participate in different productive and commercial processes of the fishing activity (such as small-scale fisheries, distant-water fisheries and processing and commercialisation companies). It focuses on the regional level (Galicia, NW Spain) and considers sustainability, governance and socioeconomic aspects from the perspective of socioecological systems. Results show similarities and differences in agents’ perceptions related with specific aspects and problems relevant to each group, intersectoral relations and sustainability issues. In this sense, agents share a positive perception of the sustainability objectives proposed by international organisations, as well as concerns about the uncertainty linked to globalisation processes. However, they differ in their evaluation of some specific regulatory measures. Regulatory policies could consider this information in order to achieve a greater degree of complicity and compliance by fishers and other agents of the value chain.

Influence of geometric factors on cyclic durability of rotor main parts of the hot section of aircraft engines. Validation using lumen control results

A study was conducted of the influence of some geometric factors on such parameters as the position of dangerous points determining the cyclic durability of a part, and the values of cyclic durability at these points. Based on the results of the validation carried out using the results of non-destructive testing and fractographic studies of opened cracks in the main part with operational defects, the adequacy - the degree of compliance with the research results - of the calculation models used to determine the cyclic durability was established. The work was carried out as part of the task of determining the resource indicators of the main part, taking into account the presence of an initial defect.

Informal, Legal, or Illegal? Varieties of Artisanal Mining in the Global South

abstract: Artisanal mining in the Global South increased during the 2002–14 commodity boom, yet variation in the informal status of miners remains understudied. The authors define the status of artisanal mining based on the degree of rule compliance and the willingness of state actors to enforce such compliance: it is legal when the miners have formal permits to operate and follow state rules to mine, but it is illegal when the mining takes places in restricted natural reserves and noncompliance with state mining rules is extensive. The article explains transitions in the informal status of artisanal miners by examining the importance of mining to the local economy and the organizational asymmetries within the sector—that is, the differences in the associative strength of artisanal mining within a region. Where artisanal mining is central to the local economy, low asymmetries help miners transition to legality while high asymmetries, by contrast, push them toward illegality and criminality. The authors process trace these transitions in Peru’s most important gold-producing regions. The findings have broad implications for other small-scale producers and merchants whose activities are also known for widespread informality.

Changes in the biological and nutritional value of pea and bean grains as a result of their bioactivation

The relevance of the study is due to the need to improve the technology for processing peas and beans of domestic selection into plant-based drinks and their use in technologies for alternative products of complex raw materials for healthy, functional and specialized nutrition of various population groups. The purpose of the work is to study the influence of the developed technological modes of bioactivation on the nutritional and biological value, functional and technological properties of the protein-carbohydrate complex of pea and bean grains. The work examines the results of studies of changes occurring in pea grains bred at the Bashkir Research Institute of Agriculture and beans bred at the Omsk State Agrarian University during their bioactivation using the Smart Sprouter "Rosinka" installation, in particular the biochemical composition and inhibitory activity of grain of the studied varieties, a protein complex and amino acid composition, protein digestibility in vitro, functional and technological properties of the protein-carbohydrate complex of grain. The research has been carried out using generally accepted, modern instrumental methods for analyzing the properties of raw materials and finished products. It has been established that the use of the developed technological parameters of bioactivation leads to modification of the functional and technological properties of the structure-forming nutrients of grain, intensive accumulation of all amino acids, with the exception of threonine, make it possible to increase the protein content in pea grain by 15.32 % and beans by 14.96 %, relative to the initial values increase the degree of compliance of pea and bean grain protein with the FAO/WHO reference protein by 4.48 and 17.53 %, reduce the activity of grain protease inhibitors by 19.76 and 26.12 %, increase the digestibility of grain protein by 7.77 and 5.85 %. The research results prove the feasibility of using bioactivated pea and bean grains for the production of alternative products with a complex raw material composition, including plant-based drinks and products in the "dairy alternatives" segment.

Evaluation of a training programme on the management of infectious and sharp healthcare waste in Tunisia

IntroductionThe management of healthcare waste is a crucial issue for public health and the environment. To minimise risks, it is essential to ensure that the management of healthcare waste is...

The (ever)changing face of news, with broadcast interviews in focus

In this paper I intend to shed light on broadcast news interviews with a focus on the increasing role of video-mediated platforms. To do so, I first overview the rules of conduct journalists are required to follow, pondering on whether the shift to video-platforms has made substantial changes to what recommended in manuals and posited in scholarly studies. Then, I illustrate a corpus-based case study of news interviews carried out by professional journalists with Chinese and Russian diplomats. Similarities and differences between face-to-face and video-mediated interviews as well as between Chinese and Russian interviewees have been identified, with special reference to (a) the format of the questions posed by the journalists, (b) their degree of compliance to the traditional ground rules of conduct in the Q&A interface, (c) the role of the interviewees’ lingua-cultural background and (d) reference to the audience.

Congeneric and Robust Adhesive Epidermal Patch for Anti‐Interference Physiological Signal Recognition

AbstractEpidermal patches utilized for the transduction of biopotentials and biomechanical signals are pivotal in wearable health monitoring. However, the shortcomings, such as inferior conformal ability, deficient adhesion, and motion artifacts, severely impede the bioelectrodes from perceiving stable and superior‐quality physiological signals. Herein, a polymer epidermal patch possessing a spontaneous Janus structure is facilely prepared through itaconic acylhydrazine (IAH) induced gradient polymerization. The solubility discrepancy of the monomers in IAH authorized the Janus structure with distinct adhesion properties on each side. Moreover, the hydrogen bond network constructed by IAH confers the polymer with a high degree of skin compliance, enabling dynamic and stable mechanical properties to withstand complex monitoring environments. By integrating skin‐like softness (Young's modulus ≈0.16 MPa), robust adhesion (35 kPa), and high signal‐to‐noise ratio (32 dB), this epidermal patch displays exceptional elasticity within the physiological activity spectrum, provides swift electrical and mechanical self‐recovery capabilities, and resists interference in dynamic signal monitoring (deformation, compression, humidity, etc.). By demonstrating multifaceted applications for Electrocardiogram recording under diverse disturbances, the epidermal patch profiles a promising noninvasive, enduring wearable bioelectronic interface with immunity to interference.

Effect of Feedback Provision on Improving Patient Safety Indices Based on Hospital Accreditation Model: A Study in Shahid Rahnemoon Hospital, Yazd

Background: Accreditation means systematic evaluation of health service centers with specific standards. One of the most important goals of the accreditation process is to improve patient safety. Patient safety visits are one of the most important standards for improving safety. One of the ways to increase the effectiveness of visits is holding feedback sessions. Objectives: The present study was conducted with the aim of assessing the effect of feedback provision on improving patient safety indices based on the hospital accreditation model in Shahid Rahnemoon Hospital, Yazd. Methods: The present study is a semi-experimental study with a before-and-after design that was conducted in Shahid Rahnemoon Hospital, Yazd, from September to December 2021 and January to August 2022. After each visit, formal feedback sessions were held with the attendance of patient safety team members and officials of the visited wards/units. Evaluation indicators included patient safety indicators in accreditation standards, such as error reporting, rate of unwanted events, and patient safety culture score. These were measured before and after feedback. The tools used were the patient safety standards evaluation checklist based on the accreditation model, the patient safety culture questionnaire, and other indicators extracted using documentation. The Patient Safety Culture Evaluation Questionnaire was completed by 360 nurses working in the hospital in the form of a census. Analysis was done using descriptive statistical tests and paired t-tests with STATA 14.2 software. Results: Based on the results of the study, safety feedback was provided to increase patient safety indicators in different departments and units of hospitals [t = - 4.8652, w/df = 10, P = 0.0007, (P = 0.05)]. A significant difference was observed in the amount of error reporting (P = 0.031) and patient safety (P < 0.001) before and after the intervention. The degree of compliance with the dimensions of the patient safety culture had a statistically significant difference before and after the intervention (P < 0.001). Conclusions: Providing a safety feedback program had a significant positive effect on the consumption and consequences of the patient’s safety culture. Therefore, conducting regular safety visits and setting up a direct feedback program to each department/unit after the visit, and the follow-up of corrective measures, will lead to an increase in patient safety standards.

The SAM-Krom biomonitoring study shows occupational exposure to hexavalent chromium and increased genotoxicity in Denmark.

Hexavalent chromium (Cr(VI)) is a carcinogen. Exposure to Cr(VI) may occur in different industrial processes such as chrome plating and stainless steel welding. The aim of this study was to assess occupational exposure to Cr(VI) in Denmark. This cross-sectional study included 28 workers and 8 apprentices with potential Cr(VI) exposure and 24 within company controls, all recruited from six companies and one vocational school. Use of occupational safety and health (OSH) risk prevention measures were assessed through triangulation of interviews, a questionnaire and systematic observations. Inhalable Cr(VI) and Cr-total were assessed by personal air exposure measurements on Cr(VI) exposed participants and stationary measurements. Cr concentrations were measured in urine and in red blood cells (RBC) (the latter reflecting Cr(VI)). Genotoxicity was assessed by measurement of micronuclei in peripheral blood reticulocytes (MNRET). At announced visits, a consistent high degree of compliance to OSH risk prevention measures were seen in 'chromium bath plating' for both technical devices (e.g. ventilation, plastic balls, sheet coverings) and in the use of personal protective equipment (e.g. gloves, respirators), yet a lesser degree of compliance was observed in 'stainless steel welding'. The geometric mean of the air concentration of Cr(VI) was 0.26μg/m3 (95% confidence interval (CI): 0.12-0.57) for the Cr(VI)-exposed workers and 3.69μg/m3 (95% CI: 1.47-9.25) for the Cr(VI)-exposed apprentices. Subdivided by company type, the exposure levels were 0.13μg/m3 (95% CI: 0.04-0.41) for companies manufacturing and processing metal products, and 0.81μg/m3 (95% CI: 0.46-1.40) for bath plating companies. Workers with occupational exposure to Cr(VI) had significantly higher median levels of urinary Cr (2.42μg/L, 5th-95th percentile 0.28-58.39), Cr in RBC (0.89μg/L, 0.54-4.92) and MNRET (1.59 ‰, 0.78-10.92) compared to the within company controls (urinary: 0.40μg/L, 0.16-21.3, RBC: 0.60μg/L, 0.50-0.93,MNRET: 1.06 ‰, 0.71-2.06). When sub-dividing by company type, urinary Cr (4.61μg/L, 1.72-69.5), Cr in RBC (1.33μg/L, 0.95-4.98) and MNRET (1.89μg/L, 0.78-12.92) levels were increased for workers with potential Cr(VI) exposure in bath-plating companies, and when subdividing by work task, workers engaged in process operation had increased levels of urinary Cr (8.51μg/L, 1.71-69.5), Cr in RBC (1.33μg/L, 0.95-4.98) and MNRET (1.89μg/L, 0.82-12.92) levels. This biomonitoring study shows that bath platers were highly exposed to Cr(VI), as suggested by relatively high levels of urinary Cr, Cr in RBC and increased levels of micronuclei. The urinary Cr concentrations were high when compared to the French biological limit value of 2.5μg Cr/L, corresponding to the Danish occupational exposure limit of 1μg/m3. This, in turn, indirectly suggests that additional exposure routes than via air may contribute to the exposure. For welders, no statistically significant increases compared to within company controls were observed, however, the observed urinary Cr levels were similar to the levels observed in a European study (HBM4EU), and were higher than the levels observed for welders in Sweden (SafeChrom). In spite of a high degree of self-reported and observed compliance to OSH risk prevention measures during announced visits, the biomarkers of exposure reflecting recent exposure (urinary Cr) or exposure during the last four months (Cr in RBC) may point to variation in compliance to OSH risk prevention measures in general. Reduced occupational exposure to Cr(VI) may be achieved by applying the hierarchy of controls in eliminating or substituting Cr(VI), and the use of more effective technical solutions (e.g. automation).

Drafting a Cybersecurity Standard for Outer Space Missions: On Critical Infrastructure, China, and the Indispensability of a Global Inclusive Approach

Despite limited progress within international institutions, the need for articulating a regulatory framework for cyber operations in outer space is becoming a pressing concern. One precondition for regulation is to share cybersecurity and outer-space common terminology that can inform the negotiation of standards, policies and laws. While the UN Institute for Disarmament Research has recently issued a baseline policy glossary, binding technical definitions are missing, and the lack of a binding international cybersecurity regime adds to the obsolescence of a binding outer-space regime tracing back to half a century ago. As the IEEE SA embarks on the drafting of the first-ever technical standard for cybersecure-by- design outer-space missions, scoping and conceptual challenges abound. Technical standards are US-centred, non-binding, engineering-intensive exercises, where lawyers and Asian jurisdictions are only marginally involved; nevertheless, as China’s framework for cybersecurity is refined and its involvement in outer-space policing deepens, its disengagement from Western-driven standard-setting bodies appears unsustainable. Drawing on the specific challenge of defining what makes a cyber system ‘mission-critical’, I expose the necessity to examine how domestic cybersecurity laws from a diverse range of States identify ‘critical’ information infrastructure. Generalising therefrom, I advocate a jurisdictionally inclusive process that combines American supremacy in technical standard-setting for outer-space missions with Chinese normative contributions to cybersecurity regulation, including on data localisation and mandatory multilevel cyber-hygiene requirements. I further argue that involving legal experts from a diverse range of jurisdictions and sociolegal cultures may enhance the global reception of standardisation outputs, thus securing higher degrees of voluntary compliance therewith. This could foster cooperation and promote regional and global satellite cybersecurity.

Bowel preparation before elective right colectomy: Multitreatment machine-learning analysis on 2,617 patients

BackgroundIn the worldwide, real-life setting, some candidates for right colectomy still receive no bowel preparation, some receive oral antibiotics alone, some receive mechanical bowel preparation alone, and some receive mechanical bowel preparation with oral antibiotics, with varying degrees of compliance to preoperative intravenous antibiotic prophylaxis. Previous studies mainly focused on left-sided colorectal anastomoses while less attention has been devoted to right-sided ileocolic anastomoses. When high-level evidence from randomized clinical trials is lacking, multiple-treatment propensity score weighting analysis of prospective data on the basis of generalized boosted model is superior to a simple propensity score-matching analysis and to an inverse probability weighting in terms of external validity and bias reduction. MethodsThis is an analysis on the basis of machine-learning procedures of 2,617 patients who underwent elective right colectomies. ResultsThe risk of surgical-site infections (5.0% after no bowel preparation) was significantly lower after mechanical bowel preparation with oral antibiotics (4.0%, P = .017), significantly greater after mechanical bowel preparation alone (8.6%, P = .019), and comparable after oral antibiotics alone (3.9%). The risk of anastomotic leakage (3.2% after no bowel preparation) was significantly greater after oral antibiotics alone (4.8%, P = .013). Concerning secondary outcomes, no significant differences were recorded for the risk of overall morbidity and reoperation. The risk of readmission (3.0% after no bowel preparation) was significantly reduced after mechanical bowel preparation with oral antibiotics (1.5%, P = .046), and the risk of major morbidity (5.1% after no bowel preparation) was significantly greater after oral antibiotics alone (6.7%, P = .007). ConclusionThis multitreatment machine-learning analysis, despite some limitations, showed that mechanical bowel preparation with oral antibiotics is associated with a decrease in surgical-site infections after elective right colectomy compared with no bowel preparation.

Advancing fiscal transparency in Latin American countries: new findings in reports on tax sustainability in Chile

PurposeThe objective of this study is to generate new fiscal transparency indicators based on fiscal sustainability reports voluntarily disclosed by Chilean companies, leaders in Latin America in the issuance of green, social and sustainability corporate bonds (OECD, 2023a; OECD, 2018).Design/methodology/approachThe sample included the analysis of sustainability reports of 30 Chilean companies with the highest market capitalization published in the period 2021. A correlation was carried out for each of the companies in the sample with the intention of detecting differences between several groups of paired dichotomous variables. For this, Cochran's Q test was used; the McNemar test; the Friedman test; the Wilcoxon test; the Levene test and the Kruskal−Wallis test were also used.FindingsIn the case of the companies in the sample, for the 2021 period there was an increase in disclosures of tax strategies compared to the study carried out by Faúndez-Ugalde et al. (2022) for the period 2020. However, there is still a lower degree of compliance in reporting fiscal risks and “country by country” information.Practical implicationsThe commitment of companies to assume tax transparency standards improves their behavior in compliance with their tax obligations and provides greater certainty to develop actions to mitigate their tax risks.Social implicationsThe results demonstrate practical implications, where fiscal sustainability reports can enhance the work of tax administrations by defining indicators of good fiscal practices.Originality/valueThis study expands the research on the fiscal sustainability standards of Chilean companies, thus providing a deeper understanding of their performance regarding fiscal transparency.

Relationship between GPS-based community mobility data and orthopedic trauma admissions during the COVID-19 pandemic in Austria: amulticenter analysis.

The main objective of this study was to examine the relationship between mobility patterns during the coronavirus disease 2019 (COVID-19) pandemic and orthopedic trauma patients in Austria. Utilizing global positioning system (GPS)-based mobility data, the attempt was to assess both the impact of COVID-19 lockdowns on reducing orthopedic trauma patients and the degree of compliance to the imposed movement restrictions. This retrospective analysis included all patients (283,501) treated at 3 major levelI trauma centers in Austria. Analyzed time periods were 1 January 2019 to 8 February 2021. Freely available GPS-based mobility data from Google and Apple Inc. was gathered. Amoderate to strong correlation between the cumulative average outpatients and the assessed mobility index was observed for all cities (Google: r = 0.70 p < 0.001, 95% confidence interval, CI: 0.67-0.73; Apple: r = 0.64 p < 0.001, 95% CI: 0.61-0.67). Asignificant linear regression equation was found for Vienna (adjusted r2 = 0.48; F(1, 350) = 328,05; p < 0.01). During the first lockdown there was adrastic decline in mobility (up to -75.36%) and in numbers of orthopedic trauma outpatients (up to -64%, from 153 patients/day 2019 to 55patients/day 2020) in comparison to the prepandemic era. The decline diminished as time passed. Analyses of GPS-based mobility patterns show acorrelation with trauma patient numbers. These findings can be used to develop prediction models, leading to better resource planning and public health policy, enhancing patient care and cost-effectiveness, especially in the event of future pandemics. Furthermore, the results suggest that compliance to mobility restrictions decreased over time during the COVID-19 pandemic, resulting in increased mobility and trauma patients.

RANKING OF SEISMIC INTENSITY ATTENUATION LAWS AND MODELING OF SEISMIC SOURCES FOR SEISMIC HAZARD ASSESSMENT IN UZBEKISTAN

Quantitative assessments of seismic hazard in seismically active areas depend to a large extent on the intensity-distance attenuation laws which are used in calculations. To account for epistemic uncertainty in the nature of seismic effects, it is recommended to perform probabilistic seismic hazard analysis using several different attenuation relationships. The most effective tool for their selection is the ranking procedure which consists in attributing a weight to one or another equation depending on the degree of compliance between the equation-based seismic effects and the real experimental data available for the region under study. The article presents the results of ranking intensity attenuation laws derived for Central Asia. Ranking was carried out by LH and LLH methods. Based on the ranking results, these has been made a generalized attenuation model used subsequently in PSHA for Uzbekistan. Consideration was given to three alternative models of seismic sources: area sources, active faults, and seismogenic zones. Parameterization of the models considered involved determining seismic potential, frequency of recurrence of earthquakes of different energy levels, and the predominant type of motions in each earthquake source. Seismic zoning maps of Uzbekistan in points of the MSK-64 intensity scale have been compiled for different probabilities of occurrence of non-exceedance level earthquakes in the next 50 years.

Degree of compliance with doctors recommendations and its effect on compensation of the disease among children and adolescents with congenital adrenal hyperplasia

Degree of compliance with doctors recommendations and its effect on compensation of the disease among children and adolescents with congenital adrenal hyperplasia

Understanding Institutional Compliance in Floor Risk Management: A Network Analysis Approach Highlighting the Significance of Institutional Linkages and Context

Governments worldwide are intensifying efforts to address escalating flood risks exacerbated by climate change. Central to this endeavor is the implementation of institutional frameworks, such as public policies, aimed at mitigating, planning for, responding to, and recovering from flood events. However, the effectiveness of these institutions relies heavily on their practical application. This study delves into the institutional landscape of flood risk management (FRM) through a comprehensive case study in Sint Maarten, a Caribbean island. Specifically, we scrutinize the degree of institutional compliance, focusing on the alignment between formally advised policies (institutions-in-form) and their informal adoption in practice (institutions-in-use). Employing Institutional Network Analysis (INA), we explore discrepancies between these two dimensions across the various phases of FRM (response, recovery, mitigation, and preparation). Our findings reveal that institutional compliance varies significantly across the FRM phases, with mitigation presenting the most pronounced challenges. Notably, the discrepancies are more prevalent among those tasked with implementing the policies rather than the targeted property owners. Generally speaking, the transition of institutions from mere forms to actionable rules is often hindered by established or emerging practices diverging from prescribed directives.

The effect of virtual reality versus standard-of-care treatment on pain perception during paediatric vaccination: Study protocol for a randomised controlled trial.

To study the effects of virtual reality (VR) on pain perception among a paediatric population while being vaccinated. We will also investigate the effects of VR on the fear experienced by children during the vaccination procedure, as well as parental satisfaction levels. Many studies, for example, in the fields of oncology, dermatology or plastic surgery, have described the benefits of using VR to reduce the perception of pain among paediatric populations. These results are encouraging, but their main limitations were the small sample sizes they included or their methodological design. This will be a randomised clinical trial. SPIRIT guidelines were followed to report this protocol, and we will use the CONSORT and CONSORT-EHEALTH guidelines to report the randomised clinical trial. The sample will comprise 148 children aged 3-14 years who will come for vaccination at the Tres Forques Health Center. The participants will be randomly allocated into intervention group (VR; n = 74) or (the control group standard-of-care; n = 74) at a 1:1 ratio. The intervention group will view experiences with a VR headset as a distraction measure. The study variables will be the level of pain and fear perceived by the child during vaccination, parental satisfaction with the vaccination procedure, and sociodemographic and vaccination variables. The start of the study is planned for September 2020, and the results will be expected in September 2021. This study aims to identify what measures reduce pain and fear in children during vaccination, which in turn, can help to improve the degree of parental satisfaction with these procedures. Vaccination is an independent function of the nursing profession. Identifying which distraction measures reduce the perception of pain and fear in the paediatric population will not only improve children's experiences but will also improve the satisfaction of both parents and children, thus increasing the degree of compliance with the vaccination schedule.