Compliance Measurements Research Articles

To file or not to file? Another dimension of tax compliance - the Eswatini Taxpayers’ survey

Non-filing, the failure to submit a tax declaration, is a widespread phenomenon in sub-Saharan Africa and produces detrimental fiscal effects, from impaired revenue mobilisation to inequality. Non-filing has been largely unexplored in the public finance literature, which focusses mosty on active filers. This paper sheds light on the determinants of non-filing, building on neoclassical and behavioural theories, and adds to the methodological discussion on how to measure tax compliance. Focusing on Eswatini, I combine survey data from one thousand entrepreneurs with their tax returns over 2013–2018. I show that economic deterrence, compliance costs and moral factors, such as intrinsic motivation and peer pressure, correlates with filing. I also study how results change when using a self-reported measure of compliance. In terms of policy, results show that the tax authority could improve filing rates by balancing a deterrent and a service-oriented approach, and also by triggering the role of social norms.

Acoustic radiation force imaging (ARFI) in the non-distended bladder does not predict abnormal urodynamic parameters in children.

Acoustic radiation force imaging (ARFI) is a recently developed form of ultrasound imaging that allows in vivo measurement of tissue stiffness. This technology could be useful at predicting bladder compliance in children. We hypothesize that tissue stiffness, as measured by ARFI, correlates with abnormal bladder compliance and capacity in patients with bladder dysfunction. Patients who presented for cystometrography (CMG) underwent ARFI of the bladder wall. Nine bladder wall shear wave speed (SWS) measurements were acquired using point and 2D ultrasound shear wave elastography. The mean for each ARFI technique was correlated to bladder compliance, calculated using Wahl's dimensionless number. ARFI parameters also were correlated with bladder capacity. A total of 25 patients were enrolled. Mean age at time of enrollment was 4.2±3.9 years (range two months to 15 years). There was no significant correlation between bladder compliance and point shear wave speed measurements (r=-0.22, p=0.31) or 2D shear wave speed measurements (r=-0.35, p=0.1). A total of 19 patients had bladder capacity below expected bladder capacity (EBC). There was no significant correlation between bladder capacity and point shear wave speed measurements (r =-0.08, p=0.7) or 2D shear wave speed measurements (r=-0.36, p=0.09). Our results did not demonstrate a significant correlation between bladder wall ARFI shear wave measurements and bladder compliance or bladder capacity. Further studies are warranted to determine whether ARFI may be used to predict abnormal urodynamic parameters in children.

Self-Reported versus observed audit: Measuring CHG bathing compliance

Measuring compliance with the appropriate chlorhexidine gluconate (CHG) bathing process through direct observation audits can be helpful in sustaining this important practice; however, capturing this data may be difficult. This study reports the differences between observed and self-reported CHG bathing process compliance audits. The difference between mean observed and self-reported compliance was not significant (p = .06), indicating that self-reported compliance may be an accurate, easy to obtain proxy measure for CHG bathing process compliance.

Does compliance with the preventive health behaviours against COVID-19 mitigate the effects of depression, anxiety and stress? (¿Cumplir con los comportamientos preventivos de salud contra el COVID-19 reduce los efectos de la depresión, la ansiedad y el estrés?)

In the present study, the aim was to investigate the associations between compliance with preventive health behaviours, depression, anxiety and stress. 478 adults living in Turkey voluntarily filled out the online survey, which comprised demographic questions, Measure of Compliance with Preventive Health Behaviours against COVID-19, and Depression Anxiety Stress Scales, between 24–31 March 2020: during the initial phase of the COVID-19 pandemic in Turkey. Results revealed that compliance with preventive health behaviours has negative associations with depression, anxiety and stress. Adults’ compliance with the recommended preventive health behaviours accounted for 14% variance in depression, 9% variance in anxiety and 10% variance in stress. The evidence might indicate that compliance with preventive health behaviours may protect people psychologically against the burden created by the novel COVID-19 pandemic.

The Effect of Calendarized Drug Package on Patients Compliance with Antibiotics

BACKGROUND: Patients’ compliance with antibiotics has been one of the global challenges in combating antibiotics resistance. Patients will tend to forget their antibiotics, especially when they feel better. Related to this phenomenon, the development of medication reminder media is essential. AIM: This experimental study was aimed to develop and apply calendarized package as a medication reminder media in patients with short-course antibiotics to improve their compliance. METHODS: Calendarized package was prepared from the labeling of the original package of antibiotics with stickers. Patients above 18 years old who were prescribed short-course oral antibiotics (not more than 7 days) during the study period were asked to participate in this study. Patients were grouped into two groups (control and intervention group). Patients’ demographical data, medications prescribed, and the last antibiotics course day was recorded. Patients were then contacted for compliance evaluation on the latest antibiotics course day. RESULTS: A total of 150 patients who met the inclusion criteria were recruited in this study. Seventy-six patients were grouped into the intervention group, while the remaining 74 patients were the control group. The results showed that the number of compliant patients in the intervention group was higher (72.37%) than those in the control group (45.95%), respectively (p < 0.000). CONCLUSION: The application of the calendar on the package indicates the positive impact on the patients’ compliance with antibiotics. However, in this study, the compliance measurement was conducted indirectly because of the coronavirus disease 2019 pandemic. However, several limitations should be considered. Future research using a bigger sample size and stricter compliance measurement method is needed to confirm this finding.

Three-year hand hygiene monitoring and impact of real-time reminders on compliance

Hand hygiene remains both the major strategy and an ongoing challenge for infection control. The main issues in the sustainability of hand hygiene automatic monitoring are healthcare worker (HCW) turnover rates and declining participation. To assess hand hygiene compliance and the impact of real-time reminders over three years. HCW compliance was observed for the use of alcohol-based hand rubs (AHR) on room entry and exit. Linear multi-level mixed models with time autocorrelations were performed to analyse the repeated measurements of daily room compliance and the effect of reminders over eight quarters (24 months). In all, 111 HCWs were observed and 525,576 activities were identified in the database. There was an improvement in compliance both on room entry and exit over two years, and the rooms which had activated reminders had better performance than the rooms which did not have activated reminders. This study showed the benefit of using real-time reminders; even 20% of rooms with an activated reminder improved overall hand hygiene compliance. A randomized real-time reminder setting may be a potential solution in reducing user fatigue and enhancing HCW self-awareness.

Biosecurity assessment in relation to the occurrence of some coccidian parasites in poultry farms, with in vitro evaluation of Psidium gujava as coccidia sporulation inhibitor.

The present study was performed to assess the correlation between biosecurity compliance measures and the prevalence of Eimeria and Cryptosporidium species in commercial based (CBF) and house hold (HHF) poultry farms, in Delta region Egypt. Additionally, this study aims to evaluate the effect of Psidium gujava on sporulation of Eimeria oocysts in bird environment (the chicken litter or manure). This study was conducted in 74 poultry farms, from which, 74 litter samples were collected for detection of both species. Additionally, 74 water samples were collected and examined for the presence of Cryptosporium spp. Concurrently a series of experiments were done separately to evaluate the efficacy of Psidium gujava. The results showed that the overall prevalence of Eimeria spp. was 48.6% with a higher prevalence in CBF (53.3%), while that of Cryptosporium spp. was 54% with the highest prevalence in HHF (62.5%). Application of farms disinfection was insignificantly affected the prevalence of both protozoan parasites. Disposal of farm wastes as land fertilizers significantly decreased the prevalence of both protozoan parasites, in contrast disposing of wastes to fish farms was associated with the highest prevalence of Eimeria spp. The highest prevalence of Cryptosporium spp. was recorded in farms that dispose dead birds to domestic rubbish. Rodent control and All in all-out system application were significantly decreased the Cryptosporium spp. prevalence (P=0.012, and 0.025 respectively). Finally, the highest sporulation inhibition percentage (SP% of 86.4) was obtained by using crude watery extract (10%) at a concentration of 2.5ml /ml after 24hr contact time.

Hospital Accreditation: A Review of Evidence, Regulatory Compliance, and Healthcare Outcome Measures

Background: Hospitals are increasingly under pressure to provide safe and high-quality care at an affordable cost. In response to this challenge, many have adopted accreditation as an internationally recognized tool to facilitate improvements in healthcare quality and patient safety. The objectives of the study were to (a) evaluate the impact of international hospital accreditation in Dubai and (b) inform policy decision-making. Methods: We adopted a literature review, analysis of violation data, and clinical performance measures. Results: The literature review suggests insufficient evidence to link accreditation to healthcare outcomes. We report a gradual increase in hospital violations and an improvement of clinical outcomes over three years, however the improvement in clinical outcome measures were not statistically significant. Conclusions: There is limited evidence to determine the impact of international hospital accreditation. Performance measures for accreditation are needed to validate the contribution accreditation may have on reducing non-compliance and improving clinical performance measures. Further research is needed to explore how well accreditation models fit within the Donabedian framework for healthcare quality.

Assessment of respiratory system compliance under pressure control ventilation without an inspiratory pause maneuver

Objective. The measurement of the static compliance of the respiratory system (C stat) during mechanical ventilation requires zero end-inspiratory flow. An inspiratory pause maneuver is needed if the zero end-inspiratory flow condition cannot be satisfied under normal ventilation. Approach. We propose a method to measure the quasi-static respiratory compliance (C qstat) under pressure control ventilation mode without the inspiratory pause maneuver. First, a screening strategy was applied to filter out breaths affected strongly by spontaneous breathing efforts or artifacts. Then, we performed a virtual extrapolation of the flow-time waveform when the end-inspiratory flow was not zero, to allow for the calculation of C qstat for each kept cycle. Finally, the output C qstat was obtained as the average of the smallest 40 C qstat measurements. The proposed method was validated against the gold standard C stat measured from real clinical settings and compared with two reported algorithms. The gold standard C stat was obtained by applying an end-inspiratory pause maneuver in the volume-control ventilation mode. Main results. Sixty-nine measurements from 36 patients were analyzed. The Bland–Altman analysis showed that the bias of agreement for C qstat versus the gold standard measurement was –0.267 ml/cmH2O (95% limits of agreement was –4.279 to 4.844 ml/cmH2O). The linear regression analysis indicated a strong correlation (R 2 = 0.90) between the C qstat and gold standard. Significance. The results showed that the C qstat can be accurately estimated from continuous ventilator waveforms, including spontaneous breathing without an inspiratory pause maneuver. This method promises to provide continuous measurements compliant with mechanical ventilation.

Resisted Sprint Training in Youth: The Effectiveness of Backward vs. Forward Sled Towing on Speed, Jumping, and Leg Compliance Measures in High-School Athletes.

Uthoff, A, Oliver, J, Cronin, J, Winwood, P, Harrison, C, and Lee, JE. Resisted sprint training in youth: the effectiveness of backward vs. forward sled towing on speed, jumping, and leg compliance measures in high-school athletes. J Strength Cond Res 35(8): 2205-2212, 2021-Resisted sprinting (RS) is a popular training method used to enhance sprinting performance in youth. However, research has only explored the effects of forward RS (FRS) training. We examined the effects of FRS and backward RS (BRS) and compared these with a traditional physical education curriculum (CON). One hundred fifteen boys (age 13-15 years) were matched for maturity and allocated to either an FRS (n = 34), BRS (n = 46), or CON (n = 35) group. Training groups towed progressively overloaded sleds (20-55% body mass) 2 d·wk-1 for 8 weeks. Pre-training and post-training data were collected for sprinting times over 10 and 20 m, countermovement jump (CMJ) height, and leg stiffness (KN). Performance remained unchanged for the CON group (all p > 0.05), whereas all variables significantly improved (p < 0.05) after BRS, and all but 10-m performance improved after FRS. Compared with the CON, BRS and FRS significantly (p > 0.05) improved CMJ (Effect size [ES] = 0.67 and 0.38) and KN (ES = 0.94 and 0.69), respectively. No differences were found between training groups. The probabilities of improving sprinting performance after BRS (∼70%) were on average ∼10 and ∼8% better than the FRS and CON groups, respectively. The BRS and FRS showed similar probabilities of improving CMJ (75 and 79%) and KN (80 and 81%), respectively, over the CON group. It seems that BRS may be a means to improve sprint performance, and regardless of direction, RS seems to be a beneficial method for improving jumping height and leg stiffness in youth male athletes.

A Systematic Review of Interventions Used to Enhance Implementation of and Compliance With the World Health Organization Surgical Safety Checklist in Adult Surgery.

The focus of this systematic review is to identify and synthesize the evidence for effectiveness of interventions to increase compliance with the World Health Organization Surgical Safety Checklist (SSC) for adult surgery. We searched a variety of databases and identified 24 peer-reviewed articles of either a quantitative (n = 17), qualitative (n = 4), or mixed-methods design (n = 3) published in English from January 1, 2008, to July 8, 2020. Interventions included modifying the ways of delivering the SSC, integrating or tailoring the SSC to local context or existing practice, promoting clinician awareness and engagement, and managing policies. Despite a lack of common outcome measures, all quantitative and mixed-methods study results showed a significant positive effect on SSC compliance. A few researchers reported nonsignificant or negative changes in certain aspects with the interventions. Additional research is needed to address SSC compliance measures globally and outcomes in developing countries.

Liquidity Management Practices of Small and Medium-Scale Enterprises in Lagos State, Nigeria

The study investigated the extent of liquidity management practices among Small and Medium-Scale Enterprises in Lagos State, Nigeria. The study made use of primary data and the population of the study comprised of 4,460 registered Small and Medium-Scale Enterprises in Lagos State based on the Nigerian government contacts database (2015). Using Taro Yamane’s formula, a sample size of 367 Small and Medium-Scale Enterprises was computed for questionnaire administration. In each Small and Medium Enterprises that was randomly sampled, questionnaires were administered to the respondents; Owner, Supervisor or Financial Manager who provided the necessary information on liquidity management practices of their firms. Data collected from the study were analysed with the use of appropriate descriptive statistics. The result of the study revealed that SMEs engaged in liquidity management practices such as cash budget (97%), bank account operation (77%), investment in current assets (67%), and making current assets available for immediate conversion into cash (71%). Use of mechanisms in the realisation of sundry debtors (64%) and collection of debts due (64%). The study, therefore, recommended that regulatory authorities should put in place an appropriate policy with compliance measures to check high volume cash transactions and cash hoarding prevalent in the economy.

Assessment of Regional Fisheries Management Organizations Efforts toward the Precautionary Approach and Science-Based Stock Management and Compliance Measures

The sustainable management of the ocean as a global food source has been prominent in recent debates due to the disproportionate rate of human consumption, depletion of fish stocks and shortcomings in conservation efforts. Criticisms from various sectors on the effectiveness of Regional Fisheries Management Organizations (RFMO) in relation to their mandates have prompted performance reviews (PRs) to evaluate their efforts in fisheries management. Among concerns are slow implementation of comprehensive harvest strategies which use science-based indicators and management principles. Moreover, RFMOs are expected to apply the precautionary approach, in the hopes of anticipating, monitoring, preventing and mitigating potential threats. The emergent themes are revealed through content analysis pertaining to cooperation and compliance being essential to fisheries management activities in conjunction with choosing the right operational approaches and the proper implementation of various fisheries regulations. Government mandates and stakeholder’s recommendations support fisheries management organizations to function more effectively. This article discusses the role of coercive, normative and mimetic pressures in RFMOs activities, as described in recent performance reviews. It then analyses how RFMOs have implemented the precautionary approach together with science-based stock management and compliance measures, utilizing recent PRs to assess progress on relevant recommendations.

Assessing the responses of smokers to requests to stop smoking on hospital grounds.

Fear of aggression is often cited as an issue for health service staff in approaching smokers who are breaching smoke-free policies. This study collected data to quantify the interactions between Health Promotion Service staff and smokers. The aim was to trial de-escalation based protocols for Authorised Inspectors and one for general staff with regards to the aggression risk to staff when approaching smokers within hospital grounds. The study design was a non-randomised trial with no control group. A standard protocol was developed, based on de-escalation techniques. The primary outcomes of the study were measures of aggression and smokers' compliance with instructions to extinguish their cigarette. Aggression was recorded using the Modified Overt Aggression Scale (MOAS). Two hundred interactions were conducted with smokers during business hours by Health Promotion Service staff. The first 100 interactions were based on an enforcement methodology typically delivered by Authorised Inspectors, while the second 100 interactions were based on an information and assistance methodology to reflect those that could be delivered by general health service staff. Only four instances of aggression were experienced, representing 2% of all interactions. Each of these was limited to verbal aggression. No self-aggression, aggression against property, or physical aggression was encountered. Smokers were significantly more compliant to instructions to extinguish their cigarette in the enforcement method (64%) than the information and assistance method (45%) (P<.001). Groups of smokers were more compliant than individual smokers in the enforcement method (76.3% compared to 56.5%, P<.05). This study quantifies the risk of aggression to health service staff conducting smoking compliance interactions using two methodologies. By following de-escalation-based protocols, staff can approach smokers in a low-risk manner and support smoke-free policy implementation and compliance. For general staff, the emphasis of interactions must be on providing information and assistance to smokers, not enforcement, as indicated by the reduced rate of immediate compliance, introducing an increased risk of escalation if enforcement is attempted. SO WHAT?: These protocols could be implemented by other health services or organisations that are seeking to optimise the involvement of staff in supporting smoke-free policies.

Paleolithic diet fraction in post hoc data analysis of a randomized cross-over study comparing Paleolithic diet with diabetes diet

<h2>Summary</h2><h3>Background</h3> Paleolithic Diet Fraction (PDF), calculated as the fraction of intake from Paleolithic food groups divided by the intake from all food groups, was developed as a measure of compliance hitherto lacking in interventional studies on Paleolithic diet. Mean PDFs in our previously published study comparing Paleolithic diet with a Mediterranean-like diet were around 80% and 40% for the two diets, respectively, and higher PDF was associated with healthier levels in several glucometabolic outcome measures. We now present PDF comparing a Paleolithic diet with a diabetes diet. <h3>Methods</h3> 13 adult patients (3 women and 10 men, mean age 64) with type 2 diabetes followed in 2005–07 a Paleolithic diet and a diabetes diet during two consecutive 3-month periods in a randomized order cross-over design study. Mean daily PDF was calculated using four-day weighed food records. Linear mixed models were used to assess associations between PDF and relative change in the outcome measures used in this study and in aggregated data from this study combined with data from the study comparing Paleolithic diet with a Mediterranean-like diet. <h3>Results</h3> Mean PDF for energy was 77% for the Paleolithic diet and 38% for the diabetes diet. The corresponding percentages for PDF for weight were 81% and 54%. A 10% higher PDF for energy was associated with 0.8% lower weight, 0.7% smaller waist circumference, 2.1% lower total cholesterol, 7.6% lower triglyceride, 2.0% lower HbA1C, 9.9% lower leptin and, in the aggregated data, also with 1.6% lower area under the curve (AUC) for glucose during an oral glucose tolerance test (OGTT). Similar results were found for PDF for weight. <h3>Conclusions</h3> A mean PDF of around 80% for a Paleolithic diet in both this study and our previous study comparing the Paleolithic diet with a Mediterranean-like diet indicate a high reproducibility of the PDF. The mean PDF of around 40% for both the diabetes diet and the Mediterranean-like diet indicates their similarity and how far removed both diets are from a Paleolithic diet in terms of food group content. The associations between higher PDF and healthier glucometabolic outcome measures indicate that this removal is unhealthy. The results from this post hoc data analysis should be corroborated in future studies. <h3>Trial registration</h3> ClinicalTrials.gov. NCT00435240. Registered 14 February 2007. Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/NCT00435240?term=tommy+jönsson&cond=paleolithic&draw=2&rank=2.

Organization of the activities of mid-level medical staff in providing care to urological patients

In the last decade, the health care system has been suffering from an imbalance of medical personnel and low efficiency in the use of nursing personnel in practical health care, which significantly affects the quality of medical care. The article reveals the main goals and objectives of the activity of mid-level medical staff in the system of providing medical care to patients in a urological hospital. The need for nurses to comply with the formulated standards is a central link in the process of organizing their activities. The effectiveness of treatment and recovery of patients without reducing the further quality of their lives depends on timely measures for care, psychological assistance, tact and compliance with ethical standards by nurses. All these factors directly affect the prospects for the treatment and rehabilitation of patients with urological pathology, as well as the performance indicators of the urological hospital.

A comprehensive assessment of endocrine-disrupting chemicals in an Indian food basket: Levels, dietary intakes, and comparison with European data

Endocrine-disrupting chemicals (EDCs) in diet are a health concern and their monitoring in food has been introduced in the European Union. In developing countries, EDC dietary exposure data are scarce, especially from areas perceived as pollution hotspots, including industrialized countries like India. Several persistent organic pollutants (POPs) act as EDCs and pose a pressure to human health mainly through dietary exposure. In the present study, a range of organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), dioxins and furans were measured in several food items collected from Indian urban (Delhi) and peri-urban (Dehradun) areas. Food basket contamination data were used to estimate EDC dietary exposure and compare it with that of the average European population estimated from available monitoring data. All the target contaminants were found in most food items, especially in dairies and meat products. OCPs were the main contributers to the measured EDC contamination. Food supplied to Delhi's markets had higher EDC contamination than that supplied to the peri-urban market in Dehradun. Despite lax compliance and control measures, Indian dietary exposure of OCPs and PBDEs were comparable with that of Europe and were lower for PCBs and dioxins. Higher meat consumption in Europe only partly explained this pattern which was driven also by the higher EDC residues in some European food items. A substantial part of endocrine disrupting potential in the diet derives from food and animal feeds internationally traded between developed and developing countries. With increasingly globalized food systems, internationally harmonized policies on EDC content in food can lead to better protection of health in both these contexts.

Narrative Review of the objective analysis of long-term outcome of the Ponseti technique: experience from Dallas.

In 2001, Texas Scottish Rite Hospital for Children (TSRH) prospectively began a clubfoot database that included all of our patients with clubfeet who were willing to enroll. Nonoperative treatment, primarily the Ponseti method, was utilized. This article summarizes the experience from Dallas treating idiopathic clubfeet using the Ponseti technique, and is based on previously published studies utilizing information from the database. Patient clinical outcomes were defined as “good” (plantigrade foot achieved either with or without a percutaneous heel-cord tenotomy), “fair” (a plantigrade foot that required a limited procedure, such as tibialis anterior tendon transfer or posterior release), or “poor” (a plantigrade foot that required posteromedial release). Nearly 95% of idiopathic clubfeet obtained initial correction using the Ponseti technique, but relapses occurred and by age two years 24% needed some surgical intervention, usually limited procedures. Use of Dimeglio’s rating system before treatment strongly correlated with the probability of a “good” outcome at two years. Objective measurements of brace wear compliance (iButton) in those who reached age two years with “good” outcomes demonstrated an unexpected pattern of diminishing use of the foot abduction orthoses over the first two years of brace wear. By the 18-month period of brace wear, 1/3 patients wore the orthoses less than 6 hours per day, and nearly half of the patients wore the orthoses less than 8 hours per day. Between ages 2–5 years, nearly 21% of the corrected clubfeet at age two years needed limited procedures to maintain/regain plantigrade positioning. Lateral weight-bearing radiographs between 18–24 months were not helpful in predicting future relapse in these patients, and are no longer routinely obtained. Following these patients for normal development is important, as nearly 9% of infants initially presenting as idiopathic clubfeet were eventually found to have another disorder including neurological, syndromic, chromosomal, or spinal abnormalities. We continue to emphasize the need to devote great attention to detail when using the Ponseti method in an effort to optimize the clinical outcomes.

CMS is only happy when it rains

CMS is only happy when it rains

ANALYSIS OF COMPLIANCE OF EAR PROTECTOR USAGE ON THE PREVENTION OF NOISE INDUCE HEARING LOSS AT STERILIZATION INSTALLATION

Noise Induce Hearing Loss (NIHL) is a work disease that is often found in industrial workers. The use of ear protectors that are in accordance with the standard along with the continuity of optimal use can reduce the risk of hearing loss due to noise in the workplace. Adherence to use ear protectors greatly affect the possibility of a person experiencing a more severe hearing loss. The purpose of this study is to prove the existence of relationship of compliance with the use of ear protectors with hearing loss due to noise in the installation of sterilization and laundry. This study used cross sectional methods. Seventeen samples were taken by consecutive sampling for audiometry examination and measurement of compliance with the use of Ear Protective Equipment. Respondents received an average score of 1.86 indicating that compliance with the use of ear protectors was sufficient. Based on the results of the measurement of the auditory threshold in 17 respondents as many as 4 respondents (23%) normal hearing and as many as 13 respondents (77%) experienced NIHL. The results of statistical tests with Pearson correlation show that the Pearson correlation coefficient number of -0.643, which means that the correlation between compliance variables with noise due to noise is 0.643. Based on the criteria above, the relationship between the two variables is significant because the number of significance is P-value / Sig 0.005 &lt;0.05. So, there is a relation between years of work with Noise Induce Hearing Loss, education and Noise Induce Hearing Loss, and compliance with the use of ear protectors with NIHL