Compliance Measurements Research Articles

Towards a European Economic Criminal Law of Human Rights

The work proposes the emergence of a new sector within economic criminal law whose objective would be the protection of human rights and the sanctioning of multinational companies. This new sector should be promoted by the EU, which in recent years and from various sources, has been enacting a set of directives and regulations that affect this area. The economic criminal law of human rights would complement the possibilities already offered by international criminal law to sanction these conducts. The basis of the new incriminations found in this work connects with the obligations to establish compliance measures (due diligence) that have been established in the United Nations Guiding Principles for Multinational Enterprises and also with the new duties of transparency linked to non-financial information.

Mental Data Protection and the GDPR

Increasingly, digital technology can be used not only to measure relevant parameters of human anatomy and activity but also to gain exploratory information about mental faculties such as cognitive processes, personal preferences, and affective states. Although decoding the conceptual and non-conceptual content of mental states is unattainable at the current stand of technology development, several digital technologies such as neural interfaces, affective computing systems and digital behavioural technologies allow to establish increasingly reliable statistical associations between certain data patterns and mental activities such as memories, intensions and emotions. Furthermore, AI and big-data analytics potentially permit to explore these activities not just retrospectively but also in real-time and in a predictive manner. These converging technological developments are increasingly enabling what can be defined the digital mind—namely the moment-by-moment quantification of the individual-level human mind. In this article, we introduce the notion of ‘mental data’, which we define as any data that can be organized and processed to infer the mental states of a person, including their cognitive, affective and conative states. Further, we analyse the existing legal protection for this broad category of “mental data” by assessing meaningful risks for individuals’ rights and freedoms. Our analysis is focused on the EU GDPR, since it is one of the most advanced and comprehensive data protection laws in the world, having also an extraterritorial impact on other legal systems. In particular, we reflect on the nature of mental data, the lawfulness of their processing considering the different legal bases and purposes, and relevant compliance measures. We conclude that, although the contextual definition of “sensitive data” might appear inadequate to cover many examples of mental data (e.g., “emotions” or other “thoughts” not related to health status, sexuality or political/religious beliefs), the GDPR – through an extensive interpretation of “risk” indexes as the EDPB proposes – seems to be an adequate tool to prevent or mitigate risks related to mental data processing. In conclusion, we recommend that interpreters and stakeholders focus on the “processing” characteristics, rather than merely on the “category of data” at issue. To achieve this goal, we call for a “Mental Data Protection Impact Assessment” (MDPIA), i.e. a specific DPIA procedure that can help to better assess and mitigate risks that mental data processing can bring to fundamental rights and freedom of individuals.

Implementing daily chlorhexidine gluconate (CHG) bathing in VA settings: The human factors engineering to prevent resistant organisms (HERO) project

Daily use of chlorhexidine gluconate (CHG) has been shown to reduce risk of healthcare-associated infections. We aimed to assess moving CHG bathing into routine practice using a human factors approach. We evaluated implementation in non-intensive care unit (ICU) settings in the Veterans Health Administration. Our multiple case study approach included non-ICU units from 4 Veterans Health Administration settings. Guided by the Systems Engineering Initiative for Patient Safety, we conducted focus groups and interviews to capture barriers and facilitators to daily CHG bathing. We measured compliance using observations and skin CHG concentrations. Barriers to daily CHG include time, concern of increasing antibiotic resistance, workflow and product concerns. Facilitators include engagement of champions and unit shared responsibility. We found shortfalls in patient education, hand hygiene and CHG use on tubes and drains. CHG skin concentration levels were highest among patients from spinal cord injury units. These units applied antiseptic using 2% CHG impregnated wipes vs 4% CHG solution/soap. Non-ICUs implementing CHG bathing must consider human factors and work system barriers to ensure uptake and sustained practice change. Well-planned rollouts and a unit culture promoting shared responsibility are key to compliance with daily CHG bathing. Successful implementation requires attention to staff education and measurement of compliance.

Assessment of the impact of electronic fiscal devices on compliance and VAT collection in Malawi

The study examined the effectiveness of using electronic fiscal devices (EFDs) in revenue collection and compliance. The study used a quantitative approach for the analysis. Timely filing of tax returns was used as a measure of compliance whereas value-added tax (VAT) revenue collection as a percentage of gross domestic product (GDP) was employed as a measure of revenue collection performance. The data used for the analysis covered July 2005 to June 2019. A sample of 318 taxpayers was used for the analysis of the level of compliance and revenue collection. The sample included a segment of 244 taxpayers using EFDs and 74 taxpayers without EFDs all being small and medium taxpayers. The results indicated that using VAT collection has not increased revenue collection in the period under review as evidenced by a decline after the EFDs were rolled out. The study also found that the mean of growth of VAT revenues in the two periods (pre- and post-EFD implementation) does not reveal any significant difference. We found that taxpayers may be inflating purchases to reduce their tax liability and increase their VAT claims as evidenced by the significance of the change in purchases in pre- and post-EFD periods ‒ the same was evident in sales fluctuations. We further found that the sales-purchases gap is not different between the two periods. In the case of the compliance rate, the findings revealed that EFDs have not been effective in increasing compliance, as shown by a decrease in timely filing of tax returns in the post-EFD era. The study, therefore, concludes that the deployment of EFDs has not resulted in increased VAT collection and compliance during the study period. The study, therefore, recommends that the Authority should consider a system that should pair sales and purchases. Further, the Authority should endeavour to understand the reasons why more taxpayers do not submit returns on time despite having EFDs.

Level of Maqāsid ul-Shari’āh’s in financial reporting standards for Islamic financial institutions

PurposeThis study aims to measure levels of Sharīʿah-compliance in Islamic financial institutions (IFIs) financial reporting standards with the objective to investigate the application of Maqāsid ul-Sharīʿah as a compliance measure reflected in the reporting standards.Design/methodology/approachThis paper adopts Maqāsid ul-Sharīʿah’s model to measure levels of Sharīʿah-compliance amongst three available financial reporting frameworks and presentation standards; international financial reporting standards (IFRS), accounting and auditing organization for Islamic financial institutions (AAOIFI), Pernyataan Standar Akuntansi Keuangan (PSAK) Syariah. NVivo 10 software is used in this paper to help measure quantitatively the compliance level of each standard.FindingsThe findings suggest that the use of Maqāsid ul-Sharīʿah leads to a more complete understanding of how the meaning of Sharīʿah and its values can be integrated into the demands of financial reporting, and hence, offering greater convergence between ethics and accounting regulations amongst IFIs.Originality/valueIt documents different context of content analysis that takes examples of Islamic financial reporting studies and uses both classical and contemporary theoretical bases. The main outputs are designed for standard setters and policymakers with expectation for Sharīʿah objectives (i.e. Maqāsid ul-Sharīʿah), to be embedded in the preparation of financial reporting standards for the IFIs. Hence, they will be able to show their full accountability then gain better trust from the stakeholders.

Pneumothorax in COVID-19 Acute Respiratory Distress Syndrome: Case Series.

ObjectiveThe study aims to describe the clinical characteristics and outcomes of patients with COVID-19 related acute respiratory distress syndrome (ARDS) who developed pneumothorax.Design and settingA retrospective chart review was performed of the electronic medical record. Patients were included if they were identified as having confirmed COVID-19 as well as pneumothorax from March 16, 2020 to May 31, 2020. Patients' demographic and clinical characteristics, mechanical ventilator parameters, lung compliance measurements and outcomes during hospitalization were collected. This case series was conducted in intensive care units at two large tertiary care centers within the Northwell Health System, located in New York State.PatientsA total of 75 patients were identified who were predominantly male (73.3%) with an average age of 62.8 years. Thirty (40%) were Hispanic, 20 (26.7%) were White, 16 (21.3%) were Asian, and nine (12%) were Black. Common comorbid conditions were hypertension (52%), diabetes mellitus (26.7%), hyperlipidemia (32.0%), and chronic pulmonary disease (8, 10.7%).Measurements and main resultsMost of the patients were diagnosed with pneumothorax while on mechanical ventilation (92%) despite overall adherence with lung-protective ventilation strategies. Average tidal volume was 6.66 mL/kg) of ideal body weight. The average positive end-expiratory pressure (PEEP) was 10.83 (cm) H2O. Lung compliance was poor, with average peak and plateau pressures of 41.9 cm H2O and 35.2 cm H2O, respectively. Inpatient mortality was high in these patients (76%). Conservative management with initial observation had a success rate (73.3%) with similar mortality and shorter length of stay (LOS) on average. Significant factors in the conservatively managed group included lack of tension physiology, the smaller size of pneumothorax, lack of underlying diabetes, presence of pneumomediastinum, and not being on mechanical ventilation during diagnosis.ConclusionDespite overall adherence to best practice ventilator management in ARDS, we observed a large number of pneumothoraces during the COVID-19 pandemic. Conservative management may be appropriate if there are no clinical signs or symptoms of tension physiology and pneumothorax size is small.

Dose Effect of Poractant Alfa in Neonatal RDS: Analysis of Combined Data from Three Prospective Studies

Aim: To evaluate the effect of the initial dose of poractant alfa on clinical outcomes in neonatal respiratory distress syndrome (RDS) and to assess adherence to treatment guidelines recommending a dose of 200 mg/kg.Methods: Records of neonates who received poractant alfa with a less invasive technique (LISA) or with the INtubate-SURfactant-Extubate (INSURE) technique were retrieved from the aggregated datasets of three prospective RDS studies conducted between 2015 and 2019. The impact of poractant dose on neonatal outcomes was analyzed by multivariate logistic regression. The primary endpoint was the need for early (<72 h of life) mechanical ventilation (MV). Typical complications of prematurity and the need for surfactant retreatment were secondary endpoints. Deviation from the 200 mg/kg dose of surfactant was a measure of compliance with the treatment guidelines. As a complementary analysis, the rates of adverse outcomes were compared for infants receiving high (200 mg/kg ±10%) and low (100 mg/kg ±10%) doses of poractant.Results: Of 994 eligible infants, 574 received poractant alfa with LISA, and 420 received poractant with INSURE. A logistic regression model using data from all 994 infants showed that the surfactant dose had a significant effect on reducing the need for MV and retreatment; the respective odds ratios were 0.92 (95% CI: 0.90–0.95) and 0.93 (95% CI: 0.90–0.96) per 10-mg/kg dose increment of poractant alfa. This dose effect was observed across all gestational age ranges and in infants treated with LISA. In newborns treated with INSURE, the dose of surfactant only influenced the rates of retreatment (p = 0.036) but not MV (p = 0.170). No impact on other neonatal outcomes was observed. In the subset of infants who received high (N = 502) and low (N = 58) doses of poractant, the high-dose group had lower rates of MV (34 vs. 48%, p = 0.042) and lower rates of retreatment (11 vs. 21%, p = 0.045). Surfactant underdosage increased with gestational age and ranged from a minimum of −3 mg/kg in <26 weeks to a maximum of −23.5 mg/kg in >32 weeks.Conclusions: The initial dose of poractant alfa significantly impacts the need for invasive ventilation and retreatment. More mature newborns are at a greater risk of underdosing.

Use Of Exhaled Nitric Oxide (FENO) As An Indirect Measure Of Compliance In Asthma

Difficult-to-treat asthma is often explained by poor adherence with controller medication. Failure to detect non-compliance, could result in inappropriate interventions; non-compliant patients who would benefit from education, adherence monitoring may instead receive invasive, expensive treatment including monoclonal therapies, bronchial thermoplasty. A clinic-based-test of compliance would be valuable.

Ultrasonographic cystometry for neurogenic bladder using elastography.

Ultrasound shear wave elastography (SWE) has been used to measure elasticity (Young's modulus: YM) in solid organs. It was reported to show a better correlation with intravesical pressure (Pves) than with compliance, supporting its potential use in noninvasive cystometry. Contrariwise, conceptually, YM should be more correlated with compliance than with Pves. To optimize the potential use of YM as a noninvasive urodynamic study, the relationship between YM, Pves, and compliance was reassessed in this study. YM was serially measured using SWE along with bladder filling. To overcome problems inherent to current compliance measurements, modified dynamic compliance was developed from cystometry by a locally weighted scatter plot smoothing algorithm. Then it was matched with YM from SWE. YM was also correlated with Pves. Furthermore, to understand the nature of YM, which was measured by ultrasound, the bladder wall's modulus, which was the mathematical assessment of YM derived from cystometric data, was also calculated and compared. Thirty-two neurogenic bladder patients were included in this study. YM correlated with Pves (r = .72, p < .0001) better than with modified dynamic compliance (r = -0.43, p < .0001). The correlation of YM with Pves was even higher than that with the calculated bladder wall's modulus (r = .52, p < .0001). YM measured by SWE associates with Pves better than with compliance, confirming the results of previous studies. SWE reflects the integration of both the holding capability of the bladder wall and urine rather than either of one, implying its potential utilization in noninvasive cystometry.

THEORETICAL BASIS AND ANALYSIS OF THE DEVELOPMENT OF PROJECT-ORIENTED BUSINESS COMPANIES

Today in the global economic crisis and the Covid / SARS-19 pandemic, issues of development and operation of business companies are more relevant than ever. The crisis of Covid-19, in addition to the global pandemic, dealt a devastating blow to the economy and business of the company, companies suffered the most financially. Development in the framework of proactive management of companies is based on following the required level of their competitiveness. This approach is adapted for business companies and connects the dynamics of external and internal business environment, the level of competitiveness, the level of innovative development, the system of goals of the business company and the system of goals of business development programs. The conceptual model of content management of the development program is analyzed, which establishes the compliance of the program goals with the main factors of competitiveness and determines the value of projects as ensuring the achievement of these goals. to ensure it. Methods of assessing the value of business projects as a measure of compliance of their results with the business objectives. The method is based on operations and properties of business projects, which allows to take into account the uncertainty of conditions and results of business projects, forming a two-parameter assessment of the value of the project - the business contribution to each goal and the degree of this contribution. This approach, in contrast to the existing ones, allows to take into account the achievement of goals in the following procedures for determining business content. It is established that synergy in business development programs is manifested in cost savings and increase the final value of business projects. The author identifies the main sources of business synergy, which are associated with costs. The formation of the effect of synergy in terms of the theory of business projects, which arises from the joint implementation of business projects under the program, which allows to assess with greater confidence the achievement of business goals and the necessary resources in uncertainty.

Bedside ultrasound assessments of jugular venous compliance to track central venous pressure change during the treatment of decompensated heart failure

Abstract Background Accurate volume status assessment is crucial for the treatment of acute decompensated heart failure (ADHF). Volume status assessment by physical exam is inaccurate, necessitating invasive measurement with right heart catheterization (RHC), which carries safety, pragmatic (scheduling, holding anticoagulants, etc) and financial burdens. Therefore, a reliable, non-invasive, cost-effective alternative is desired. Previously, we developed an ultrasound (US) based technique to measure internal jugular vein (IJV) compliance during RHC which was used for single time point central venous pressure (CVP) predictions. We now aim to apply this technique to track acute changes in CVP during diuresis for ADHF in patients with an in-dwelling pulmonary artery catheter. Purpose The objective of our study was to devise a rapid, portable and reliable alternative to RHC to track acute volume changes during treatment of ADHF. Methods We used an observational, prospective study design and recruited 15 patients from the CCU between 7/19–12/19 being treated for ADHF (systolic or diastolic) with IV diuretics +/−inotropic agents who underwent PA catheter insertion for continuous CVP monitoring. 13 of 15 patients received milrinone infusions. US images of the IJV were obtained at end expiration and during the strain phase of Valsalva at multiple 2–3 hr intervals. Change in IJV cross sectional area (ImageJ) was used as a measure of IJV compliance. Patients unable to perform the Valsalva maneuver and on mechanical circulatory support were excluded. Results Calculated % change in CSA of IJV was plotted against CVP. An inverse relationship was observed between CVP and % change in CSA of IJV. The data was fit with an inverse exponential regression shown in Figure 1 (R2=0.36, root mean square error = 3.19). Fivefold cross validation showed a stable model for predicting CVP based CSA (R2=0.34, root mean square error = 3.26) Conclusion Serial portable US assessment of IJV compliance can act a surrogate measure of CVP and,therefore, can provide reliable information on acute hemodynamic changes in ADHF. Funding Acknowledgement Type of funding source: None

The social dimension of barrier effects of transport infrastructure

Motorways and railways increase regional accessibility but can at the same time reduce local accessibility by creating barriers in pedestrian and bicycle networks. This can influence several SDGs, such as SDG 5 (gender equality), 10 (reduced inequalities), and 11 (sustainable cities and communities). This paper presents some first principles of how quantitative indicators of direct barrier effects can be adapted in order to address specific social groups. To demonstrate this, the indicator ‘Choice’, from a set of four indicators previously developed, was adapted to assess accessibility by children to parks, and waterside and leisure facilities. The indicator was applied to a case in Gothenburg, Sweden, where a GIS-based analysis measured changes in barrier effects brought about by hypothetically placing an existing motorway and railway in tunnels. The results demonstrate how such local accessibility indicators can be adapted to make them relevant for impact assessments of infrastructure projects, and thus enable the measurement of compliance with social sustainability targets in transportation infrastructure planning.

Improving Public Sector Management at Scale? Experimental Evidence on School Governance India

We present results from a large-scale experimental evaluation of an ambitious attempt to improve management quality in Indian schools (implemented in 1,774 randomly-selected schools). The intervention featured several global “best practices” including comprehensive assessments, detailed school ratings, and customized school improvement plans. It did not, however, change accountability or incentives. We find that the assessments were near-universally completed, and that the ratings were informative, but the intervention had no impact on either school functioning or student outcomes. Yet, the program was perceived to be successful and scaled up to cover over 600,000 schools nationally. We find using a matched-pair design that the scaled-up program continued to be ineffective at improving student learning in the state we study. We also conduct detailed qualitative interviews with frontline officials and find that the main impact of the program on the ground was to increase required reporting and paperwork. Our results illustrate how ostensibly well-designed programs, that appear effective based on administrative measures of compliance, may be ineffective in practice. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

FATF’s Concerns and Pakistan's Measures for Compliance

Since August 2018, Pakistan has been dealing with the Financial Action Task Force (FATF) to avoid its harsh conditions. The aim of the study was to examine the current position of Pakistan vis-à-vis the conditions laid down by the FATF. A literature review was conducted to assess the situation over 20 months and a comparative analysis was done. Findings of the study showed that the ministry took nine actions. First, it banned two main and eleven affiliated organizations. Second, it froze 976 moveable and immovable assets of the banned organizations. Third, it intervened in the social welfare activities conducted by the banned organization and seized relevant institutes. Fourth, it ministry convicted more than 200 individuals concerned. Fifth, it appropriated funds amounting to Rs 2,400 million. Sixth, it introduced the mutual legal assistance law and contacted about 84 countries to glean information from them. Seventh, it formulated asset-freezing regulations. Eight, it introduced the charity law across the country. Ninth, it tri-furcated the 4th schedule of the Anti-Terrorism Act of 1997 and established procedures for watching the prospective offenders. The result was that, in 20 months, Pakistan formulated policies meant for curbing money laundering and combating terrorism financing.

A new noninvasive method for measurement of dynamic lung compliance from fluctuations on photoplethysmography in respiration.

Lung compliance is important in interstitial lung disease (ILD). However, the measurement requires placement of an esophageal pressure probe and is therefore not done in routine clinic practice. This study was performed to develop and verify a new noninvasive method for estimation of dynamic lung compliance (Cdyn) with a photoplethysmograph (PPG) of pulse wave represented as the changes of absorbance of green LED for hemoglobin and to examine its usefulness. A system for measuring Cdyn in combination with changes in estimated pleural pressure (Ppl) from the fluctuations on PPG with respiration and lung volume measured simultaneously by spirometry was developed and verified to show correspondence with the estimated Ppl and the esophageal pressure (Pes), estimated Cdyn, and Cdyn measured with an esophageal balloon. Furthermore, the estimated percentage of predicted Cdyn (%Cdyn) was compared among healthy subjects (HS) (n = 33) and patients with chronic obstructive pulmonary disease (COPD) (n = 31) and ILD (n = 30). Both estimated Ppl and Cdyn were significantly correlated with Pes (r = 0.89) and measured Cdyn (r = 0.63), respectively. The estimated %Cdyn in ILD showed significantly lower values than those in HS and COPD. The estimated %Cdyn was significantly related to percentage of predicted vital capacity (VC) (r = 0.57, P < 0.01) and percentage of predicted diffusion capacity of carbon monoxide (DlCO) (r = 0.50, P < 0.01) in patients with ILD. These findings suggested that the newly developed noninvasive and convenient method for Cdyn estimation using a combination of PPG and spirometry may be useful for the assessment of lung fibrosis in ILD.NEW & NOTEWORTHY Our newly developed method for measuring dynamic lung compliance (Cdyn) in combination with changes in estimated intrathoracic pressure from fluctuations on photoplethysmography with respiration and lung volume measured simultaneously by spirometry showed good linear regression between the estimated Cdyn and the Cdyn measured with an esophageal balloon, and the estimated percentage of predicted Cdyn (%Cdyn) showed significantly lower values in patients with interstitial lung disease (ILD) than in healthy subjects and chronic obstructive pulmonary disease (COPD) patients and significant correlations with vital capacity and lung diffusion capacity.

Consumer protection in E-tailing computer sales: a case study of Dell

ABSTRACT E-tailing is an important feature of e-commerce in general. This is particularly true for the Dell Corporation (Dell). Literature on Dell generally focuses on its competitive features in direct sales, products and services, overlooking its e-consumer protection. This paper aims to address this gap by reviewing the information available on Dell’s (Australia) website and secondary data to examine: (i) the current e-consumer protection regulatory framework, using Australia as a case study; (ii) consumer protection by Dell; (iii) consumer experiences with Dell; and (iv) implications for theories and practices concerning e-consumer protection. Overall, Dell has adhered to its corporate governance to comply with the existing legal framework for customer protection; however, less consistent with consumer redress. The study proposes that better treatment and education of consumer rights may help e-tailers retain existing customers and attract new customers. A blend of regulatory improvement and changes in stakeholders’ mindset and behaviour are essential to enhance e-consumer protection. Proper compliance measures, including both regulatory and non-regulatory, are required to protect the interests of both e-tailers and e-consumers.

Beware of Toothless Tigers: Institutionalizing Whistleblowing May Crowd Out Compliance

Internal whistle-blowing systems are supposed to fight misconduct within organizations. Because it is difficult to study their efficacy in the field, scientific evidence on their performance is rare. This is problematic, because these systems bind substantial resources and might generate the erroneous impression of compliance in a company in which misconduct is prevalent. We therefore suggest a versatilely extendable experimental workhorse that allows the systematic study of internal whistle-blowing systems in the lab. As a first step, we tested the efficacy of whistle-blowing systems if internal punishment for misconduct is mild and hesitant which is usually the case in practice, as several fraud surveys confirm. Our results show that under these conditions almost nobody blew the whistle, and misconduct occurred even more frequently with than without a whistle-blowing system. The institutionalization of whistle-blowing seemed to crowd out the intrinsic motivation to act compliantly. Moreover, when a whistle-blowing system was either unavailable or not used, misconduct was highly contagious and spread quickly. Yet, when we implemented severe and ensured punishment for misconduct, whistle-blowing systems could deter wrongdoing. In such a setting, people were willing to blow the whistle and the prevalence of misconduct dropped substantially. Altogether, our results highlight the interaction between institutions and preferences and can support the design of compliance measures within organizations. For compliance managers a key takeaway is that if companies preach a zero-tolerance policy, they should practice it as well. Otherwise, they might even worsen the situation.

Allergen-specific immunotherapy in dogs with atopic dermatitis: is owner compliance the main success-limiting factor?

While the efficacy of allergen-specific immunotherapy (ASIT) to treat canine atopic dermatitis has been well established, it remains unclear why not all dogs show the same response to treatment. The goal of the study was to determine the relationship between duration of ASIT and two measurements of success: disease severity and concomitant medication sparing effect. Data were retrospectively compiled for 145 dogs with atopic dermatitis treated with ASIT. As a measure of treatment compliance, cases were stratified into dogs treated for less than 12 months or for at least 12 months. Treatment efficacy, defined as a reduction in disease severity score (scale 0-10), was compared between both groups, and correlations between treatment success and several related factors were examined. ASIT treatment duration was strongly correlated with treatment efficacy. Animals treated for less than 12 months showed lower efficacy rates (22 per cent) than those treated for at least 12 months (65 per cent). Further, in animals treated for at least 12 months, concomitant medications were reduced more (87 per cent) than in animals treated for less than 12 months (39 per cent). A lack of owner compliance emerged as the main factor explaining the reduced effectiveness of ASIT. To improve treatment adherence, veterinarians and owners need to be better informed about ASIT mechanisms of action before starting treatment.

How effective are enforcement measures for compliance with the minimum wage? Evidence from Germany

The extent of non-compliance with minimum wages is heavily debated, but little is known about the effectiveness of enforcement measures. Following the introduction of a national minimum wage in Germany in 2015, employers in a catalogue of industries deemed at high risk of non-compliance were subject to more stringent enforcement requirements, such as an obligation to record hours worked. Using national administrative employment data, in this study the authors exploit the variation in enforcement measures to analyze the effect on non-compliance. As an empirical strategy, they balance jobs from industries with stricter enforcement measures with jobs from other industries and apply difference-in-differences estimations. The evidence points to a small compliance-enhancing effect of the enforcement measures. The gains in compliance are not offset by more pronounced employment losses in those industries subject to stricter enforcement.

Cardiac Reserve and Exercise Capacity: Insights from Combined Cardiopulmonary and Exercise Echocardiography Stress Testing

Cardiopulmonary exercise testing (CPET) represents the gold standard to estimate peak oxygen consumption (VO2) noninvasively. To improve the analysis of the mechanisms behind effort intolerance, we examined whether exercise stress echocardiography measurements relate to directly measured peak VO2 during exercise in a large cohort of patients within the heart failure (HF) spectrum. We performed a symptom-limited graded ramp bicycle CPET exercise stress echocardiography in 30 healthy controls and 357 patients: 113 at risk of developing HF (American College of Cardiology/American Heart Association stage A-B) and 244 in HF stage C with preserved (HFpEF, n=101) or reduced ejection fraction (HFrEF, n=143). Peak VO2 significantly decreased from controls (23, 21.7-29.7mL/kg/minute; median, interquartile range) to stage A-B (18, 15.4-20.7mL/kg/minute) and stage C (HFpEF: 13.6, 11.8-16.8mL/kg/minute; HFrEF: 14.2, 10.7-17.5mL/kg/minute). A regression model to predict peak VO2 revealed that peak left ventricular (LV) systolic annulus tissue velocity (S'), peak tricuspid annular plane systolic excursion/systolic pulmonary artery pressure (right ventricle-pulmonary artery coupling), and low-load left atrial (LA) reservoir strain/E/e' (LA compliance) were independent predictors, in addition to peak heart rate, stroke volume, and workload (adjusted R2=0.76, P<.0001). The model was successfully tested in subjects with atrial fibrillation (n=49) and with (n=224) and without (n=163) beta-blockers (all P<.01). Peak S' showed the highest accuracy in predicting peak VO2<10mL/kg/minute (cut point≤7.5cm/sec, area under the curve=0.92, P<.0001) and peak VO2>20mL/kg/minute (cut point>12.5cm/sec, area under the curve=0.84, P<.0001) in comparison with the other cardiac variables of the model (P<.05). Peak VO2 is directly related to measures of LV systolic function, LA compliance, and right ventricle-pulmonary artery coupling, in addition to heart rate and stroke volume and independently of workload, age, and sex. The evaluation of cardiac mechanics may provide more insights into the causes of effort intolerance in subjects from HF stages A-C.