Issue Of Noncompliance Research Articles

VAT and the Cross-Border Digital Economy in Africa: An Issue of Non-Compliance or Design?

Collecting VAT on cross-border e-commerce transactions has become a priority for states around the globe, including on the African continent. Following the international (OECD) guidelines, most countries require non-resident businesses to register in the state of consumption and remit the VAT on their B2C e-commerce supplies. While this may work in certain countries where the value of e-commerce is high, it is not the case in most African countries, where there is no real incentive for businesses to register and no real risk of sanctions in case of non-compliance. In this article, the author argues that mandatory registration of foreign businesses is hardly enforceable in developing economies, and that another approach might be needed for these countries.

The Issue of Noncompliance in Attention Check Questions: False Positives in Instructed Response Items

Attention checks detect inattentiveness by instructing respondents to perform a specific task. However, while respondents may correctly process the task, they may choose to not comply with the instructions. We investigated the issue of noncompliance in attention checks in two web surveys. In Study 1, we measured respondents’ attitudes toward attention checks and their self-reported compliance. In Study 2, we experimentally varied the reasons given to respondents for conducting the attention check. Our results showed that while most respondents understand why attention checks are conducted, a nonnegligible proportion of respondents evaluated them as controlling or annoying. Most respondents passed the attention check; however, among those who failed the test, 61% seem to have failed the task deliberately. These findings reinforce that noncompliance is a serious concern with attention check instruments. The results of our experiment showed that more respondents passed the attention check if a comprehensible reason was given.

Development of Nanosensors Based Intelligent Packaging Systems: Food Quality and Medicine.

The issue of medication noncompliance has resulted in major risks to public safety and financial loss. The new omnipresent medicine enabled by the Internet of things offers fascinating new possibilities. Additionally, an in-home healthcare station (IHHS), it is necessary to meet the rapidly increasing need for routine nursing and on-site diagnosis and prognosis. This article proposes a universal and preventive strategy to drug management based on intelligent and interactive packaging (I2Pack) and IMedBox. The controlled delamination material (CDM) seals and regulates wireless technologies in novel medicine packaging. As such, wearable biomedical sensors may capture a variety of crucial parameters via wireless communication. On-site treatment and prediction of these critical factors are made possible by high-performance architecture. The user interface is also highlighted to make surgery easier for the elderly, disabled, and patients. Land testing incorporates and validates an approach for prototyping I2Pack and iMedBox. Additionally, sustainability, increased product safety, and quality standards are crucial throughout the life sciences. To achieve these standards, intelligent packaging is also used in the food and pharmaceutical industries. These technologies will continuously monitor the quality of a product and communicate with the user. Data carriers, indications, and sensors are the three most important groups. They are not widely used at the moment, although their potential is well understood. Intelligent packaging should be used in these sectors and the functionality of the systems and the values presented in this analysis.

A Legal Address of a Micro-Enterprise in the Digital Economy: Approaches Transformation

The paper examines the issue of non-compliance of the current legislative requirements applied to the micro-enterprise address with the realities of the digital economy. The paper analyzes the problems of law enforcement and legislative initiatives in this field, provides for the proposals to improve the legal regulation. The author favors approach according to which the actual address is not required to register a business enterprise. A fundamental change in the approaches applied to control creation and activities of legal entities will require not only the political will to stop exerting undue pressure on business, but also to resolve a great deal of emerging legal problems (for example, location of the documents of the legal entity), since this approach allows the state registration of legal entities to perform its function of collecting and providing information.

Bayesian sequential monitoring design for two‐arm randomized clinical trials with noncompliance

In early-phase clinical trials, interim monitoring is commonly conducted based on the estimated intent-to-treat effect, which is subject to bias in the presence of noncompliance. To address this issue, we propose a Bayesian sequential monitoring trial design based on the estimation of the causal effect using a principal stratification approach. The proposed design simultaneously considers efficacy and toxicity outcomes and utilizes covariates to predict a patient's potential compliance behavior and identify the causal effects. Based on accumulating data, we continuously update the posterior estimates of the causal treatment effects and adaptively make the go/no-go decision for the trial. Numerical results show that the proposed method has desirable operating characteristics and addresses the issue of noncompliance.

Compliance, Detection, and Mergers and Acquisitions

Firms operate under a wide range of rules and regulations. These include, for example, environmental regulations (in which some industries have increased regulatory exposure) and finance and accounting (where all industries have reporting requirements). In other areas, such as antitrust cartels, enforcement is unregulated, and antitrust leaves the market as the default tool to police against anticompetitive behavior. In all of these areas, detection of noncompliance by a firm can result in significant penalties. This issue of noncompliance has implications in the merger and acquisitions (M&A) context. In a transaction between an acquiring firm (buyer) and a target firm (seller), there is asymmetric information about the target's quality. In our framework, we link a target's quality directly to the strength of its regulatory compliance. In an M&A transaction, an acquirer seeks information about the target's compliance, as a compliance failure may result in substantial penalties and sanctions, post‐acquisition. In the presence of quality (compliance) uncertainty about target firms, low‐quality targets can masquerade as high quality. This would tend to give rise to an M&A market with Lemons‐like characteristics, resulting in low transaction prices and dampening of M&A activity. We examine how M&A transactions in such regulatory areas – environmental, finance and accounting, and antitrust compliance problems – might function to alleviate quality uncertainty. Copyright © 2013 John Wiley & Sons, Ltd.

Disparities and Challenges in Adherence to Oral Antineoplastic Agents

The issue of medication noncompliance is becoming increasingly important in oncology as more cancer therapies are delivered orally. Medication adherence is difficult to assess and there is no gold standard of measurement. The act of measuring adherence can affect outcomes. Medication noncompliance is common, and is estimated to be 50% in treatment of chronic diseases. Studies have shown that women initiate adjuvant hormonal therapy for breast cancer 64% to 88% of the time when prescribed. Of those who initiate therapy, 50% to 80% are adherent for the prescribed duration, depending on the study. Patients noncompliant with adjuvant hormonal therapy for breast cancer have worse overall survival than their counterparts. Suboptimal treatment responses in chronic myeloid leukemia (CML) are also associated with medication noncompliance. Poor adherence can also affect clinical trial results, leading to inaccuracies of treatment efficacy. Barriers to compliance can occur on the individual, cultural, or system level. Examples of specific barriers are side effects, cost and access to medication, and individual health beliefs. Specific populations, including racial minorities, elderly patients, and very young patients, may be at higher risk for medication noncompliance. Strategies to improve compliance are multifactorial and include improvement of patient education, reduction of treatment side effects, interventions to alter behavior, and changes in public policy to improve financial barriers to treatment. Technology has been an effective tool in improving compliance in noncancer-related illness, and ongoing studies are evaluating its role in the oncology population.

Non-Compliance with Standard Precautions: System Theory Approach

The standard precautions are measures to prevent the transmission of infection in health care setting. Non compliance with the guidelines of standard precautions has increased the rates of hospital associated infections. This paper aims at discussing the issue of non compliance with standard precautions faced by health care organization and its significance in terms of morbidity and mortality. The issue of non compliance is analyzed by using system theory approach. The system consist of five components; input, throughput, output, feedback, and environment. The paper also highlights the factors contributing to non compliance with standard precautions. These factors are categorized as knowledge, practice and attitude towards standard precautions. The recommendations to improve compliance with standard precautions at individual and organizational level have also been discussed.

Disparities and Challenges in Adherence to Oral Antineoplastic Agents

The issue of medication noncompliance is becoming increasingly important in oncology as more cancer therapies are delivered orally. Medication adherence is difficult to assess and there is no gold standard of measurement. The act of measuring adherence can affect outcomes. Medication noncompliance is common, and is estimated to be 50% in treatment of chronic diseases. Studies have shown that women initiate adjuvant hormonal therapy for breast cancer 64% to 88% of the time when prescribed. Of those who initiate therapy, 50% to 80% are adherent for the prescribed duration, depending on the study. Patients noncompliant with adjuvant hormonal therapy for breast cancer have worse overall survival than their counterparts. Suboptimal treatment responses in chronic myeloid leukemia (CML) are also associated with medication noncompliance. Poor adherence can also affect clinical trial results, leading to inaccuracies of treatment efficacy. Barriers to compliance can occur on the individual, cultural, or system level. Examples of specific barriers are side effects, cost and access to medication, and individual health beliefs. Specific populations, including racial minorities, elderly patients, and very young patients, may be at higher risk for medication noncompliance. Strategies to improve compliance are multifactorial and include improvement of patient education, reduction of treatment side effects, interventions to alter behavior, and changes in public policy to improve financial barriers to treatment. Technology has been an effective tool in improving compliance in noncancer-related illness, and ongoing studies are evaluating its role in the oncology population.

The Noncompliant Patient: A Kantian and Levinasian Response

When a patient fails to follow the advice or prescription of a physician, she is termed to be "noncompliant" by the medical community. The medical community's response to and understanding of patient noncompliance fails to acknowledge noncompliance as either a relational failure between physician and patient or as a patient choice. I offer an analysis of Immanuel Kant and Emmanuel Levinas that refocuses the issue of noncompliance by examining the physician role, the doctor-patient relationship, and the nature of responsibility.

The Issue of Noncompliance among Health Care Providers

The Issue of Noncompliance among Health Care Providers

International Responses to Iranian Nuclear Defiance: The Non-Aligned Movement and the Issue of Non-Compliance

This article explores the responses of the non-nuclear-weapon states (NNWS) to Iran's vio- lation of the Nuclear Non-Proliferation Treaty (NPT), focusing on the stance adopted by members of the Non-Aligned Movement (NAM) in the International Atomic Energy Agency (IAEA). In February 2006, key NAM members voted to refer Iran to the UN Security Coun- cil in a move that stunned Iranian diplomats, and seemed to signal a collapse in NAM soli- darity on fundamental non-proliferation issues. This article assesses the signifi cance of this event, analysing the extent to which it represents a softening in the ideological divide between NAM and Western approaches to third-party non-compliance, and a convergence in attitudes towards the nuclear non-proliferation regime more generally. It draws on the interlinking concepts of international system, international society and global society to help explain these developments, exploring the hurdles and opportunities associated with any attempt to build on the fragile consensus emerging among the NNWS over the need to respond more decisively to NPT violations.

Delapril plus Indapamide

Although many data indicate that the management of hypertension has improved over the last two decades, there is still a large proportion of hypertensive individuals who do not receive adequate management of their blood pressure (BP). Combination therapy with two or more antihypertensive agents from different drug classes is increasingly being recognised as the most effective means of achieving target BP values by pharmacological means, particularly in the large number of patients in whom monotherapy proves to be ineffective. Use of an angiotensin-converting enzyme (ACE) inhibitor combined with a diuretic is a well established antihypertensive combination that is very effective because of the different, yet synergistic, mechanisms of actions of agents from these two drug classes. Delapril is a potent antihypertensive ACE inhibitor, and indapamide is a thiazide-like diuretic with additional antihypertensive properties. The combination of delapril and indapamide provides renoprotective effects, and indapamide is also cardioprotective. Use of these two drugs together is therefore a rational selection for combination therapy, and one that has consistently demonstrated lowering of BP to target values with a level of efficacy that is at least as good as other combinations of ACE inhibitors and diuretics. This combination has also been found to provide favourable effects on haemodynamic parameters, including left ventricular mass index and ejection fraction. Furthermore, combining an ACE inhibitor and a thiazide-type diuretic has been associated with a decreased risk of stroke and is recommended for patients with cerebrovascular disease, a setting in which the combination of delapril and indapamide has therapeutic potential. Because of the additive mechanisms of delapril and indapamide, the dose required for an effective antihypertensive effect is relatively low, and the combination is well tolerated at such doses. In particular, metabolic effects normally associated with diuretics are rare at the therapeutic dose of indapamide used in combination with delapril, making the combination suitable for patients with metabolic disorders in whom diuretic therapy would otherwise not be recommended. Delapril 30 mg and indapamide 2.5mg have been combined in a fixed combination, offering the convenience of a one-tablet-per-day antihypertensive drug regimen for most patients, which, along with good tolerability, helps to address the issue of noncompliance.

Drug policy by analogy: well, it's like this...

Drug policy by analogy: well, it's like this...

Increasing children’s compliance with oral chemotherapy through partnership

Oral antimetabolites are the main drugs in the treatment of acute lymphoblastic leukaemia in children. However, children’s compliance with oral chemotherapy has been under question for many years. Nurses need to be aware of the possibility of non-compliance among this population and be involved in developing techniques and strategies in an attempt to minimise this problem. This article discusses how developing partnerships with families can help nurses tackle the issue of noncompliance in children.

Parental non-compliance--a paediatric dilemma. A medical and psychodynamic perspective.

Considerable resources have been directed towards the recognition and management of child physical and sexual abuse and/or neglect. However, the issue of parental non-compliance is less well defined and under recognized. While outwardly seeking advice, non-compliant parents, especially if anxious, are unable or unwilling to comply with the recommendations made. Conflicts of interest between the parent(s)' and the health professionals' perceptions regarding the best interest of the child may arise. Parental non-compliance is centred around the parents' perception of the child's current problems and its relationship to past problems. Such non-compliance may reflect ignorance or misunderstanding of the clinical situation. Ignorance may be readily addressed if the parents are receptive and trusting. However, non-compliance more commonly arises from the parents' inability to cope emotionally with the stresses surrounding the recommended treatment. Parents may be vulnerable to psychological reactions which inhibit rational thinking. Parental anxieties are best understood in terms of psychological constructs, including 'defences' such as 'denial' and 'splitting', 'repetition compulsion' and the need to 'work through' psychological barriers so that the child's best interest is served. Parental non-compliance can serve to protect the parents from overwhelming fears and anxieties, which if addressed may transform parental defensiveness to co-operation. Extreme parental non-compliance may represent a special form of child abuse where, due to parental psychopathology, parents are unable to consider the child's best interest. Clinical vignettes arising from a consultant private and hospital ambulatory setting will focus on management strategies for successful outcomes. Recommendations offered on ways to reduce the risk of parental non-compliance include building trust, eliciting the aid of a parental partner, and organizing a second opinion, thereby improving the chances of a successful outcome.

Applications of multiple imputation in medical studies: from AIDS to NHANES.

Rubin's multiple imputation is a three-step method for handling complex missing data, or more generally, incomplete-data problems, which arise frequently in medical studies. At the first step, m (> 1) completed-data sets are created by imputing the unobserved data m times using m independent draws from an imputation model, which is constructed to reasonably approximate the true distributional relationship between the unobserved data and the available information, and thus reduce potentially very serious nonresponse bias due to systematic difference between the observed data and the unobserved ones. At the second step, m complete-data analyses are performed by treating each completed-data set as a real complete-data set, and thus standard complete-data procedures and software can be utilized directly. At the third step, the results from the m complete-data analyses are combined in a simple, appropriate way to obtain the so-called repeated-imputation inference, which properly takes into account the uncertainty in the imputed values. This paper reviews three applications of Rubin's method that are directly relevant for medical studies. The first is about estimating the reporting delay in acquired immune deficiency syndrome (AIDS) surveillance systems for the purpose of estimating survival time after AIDS diagnosis. The second focuses on the issue of missing data and noncompliance in randomized experiments, where a school choice experiment is used as an illustration. The third looks at handling nonresponse in United States National Health and Nutrition Examination Surveys (NHANES). The emphasis of our review is on the building of imputation models (i.e. the first step), which is the most fundamental aspect of the method.

Effects of intravenous and oral dexamethasone on selected lymphocyte subpopulations in normal subjects

Our studies describe the effects of 1 mg oral (PO) and intravenous (IV) administration of dexamethasone (DEX) on certain subpopulations of circulating lymphocytes in normal subjects. We compared the outcomes of PO and IV DEX administration because of individual differences in gastro-intestinal absorption of DEX and the issue of noncompliance in patients undergoing the dexamethasone suppression test (DST). Both routes of DEX administration were equally effective in suppressing plasma cortisol levels below 5 μg/dl, the customary criterion level. Both routes of DEX administration also significantly decreased the percent and absolute number of CD4+ cells, the CD4+/CD8+ ratio, and the percent and absolute number of virgin, but not of memory, CD4+ cells.

Compliance During Treatment of Epilepsy

Noncompliance is a major factor in suboptimal control of epileptic seizures. As many as one-third to one-half of persons with epilepsy may be noncompliant. Noncompliance negates the usefulness of the advances made in the diagnosis and treatment of epilepsy and is perhaps the single most important factor in increasing the costs of care for people with epilepsy. Although the issue of noncompliance is very complex, realization that it is a multidimensional problem and varies from patient to patient should help individualize its evaluation and approach. Noncompliance can be described by three dimensions: behavior, extent, and intentionality. The simplest methods for determining noncompliance are measurements of the antiepileptic drug concentration and patient interview. Calculation of a coefficient of variation for serial anticonvulsant drug levels may be more descriptive, however. Education and devices to simplify dosing are the primary strategies for improving compliance.

Double-blind as a BHAT-Reply

In Reply.— I would like to thank Dr Spodick for his comments concerning our article. However, the question he raised cannot be addressed because, as stated in the article, patients were asked to guess their treatment group assignment at the conclusion of the trial. Therefore, only survivors were questioned. With respect to Dr Morgan's editorial, some additional comments may be made. First, concerning the issue of unblinding and a possible placebo effect, no trial is completely blinded. The use of an unambiguous outcome (such as mortality) diminishes the chance of bias. Moreover, with respect to the β-Blocker Heart Attack Trial, there was no evidence of differential follow-up behavior between those patients who correctly guessed their treatment group assignment and those who did not. Second, the issue of noncompliance was recognized before the β-Blocker Heart Attack Trial began and the sample size was substantially increased (from 2,200 to 4,000) to account