Errorless academic compliance training is a proactive, noncoercive approach to treating oppositional behavior in children. Three teaching staff in a special education classroom were trained to conduct this intervention with three male students diagnosed with autism. During baseline, staff delivered a range of classroom requests and recorded student compliance with these requests. A hierarchy (of 4 levels) of compliance probabilities for requests was then calculated. Requests ranged from Level 1, those yielding high compliance, to Level 4, those leading to oppositional responding. At the beginning of intervention, teaching staff delivered Level 1 requests, providing praise and other reinforcement for compliance. Subsequent levels were faded in gradually over time. By the end of intervention, students demonstrated substantially improved compliance to requests that had yielded high levels of noncompliance before intervention. Follow-up at 4 weeks indicated that treatment gains were maintained. Covariant improvement in academic on-task skills was also evident.

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Noncompliance in students with Emotional/Behavioral Disorders (EBD) can contribute to difficulty with peer and teacher relationships and may result in reduced time for academic instruction. The Precision Request, an intervention which uses alpha commands, verbal praise, and reductive consequences, has been shown to increase compliance in students with EBD, but no studies have accounted for which component is responsible for the change. This study used an ABCDAX add-in component analysis to determine which component of the Precision Request produced the most effect on behavioral compliance in five sixth-grade elementary students with EBD. Data were collected on percent of student compliance, latency to compliance, and teacher and paraprofessional use of verbal praise and reductive consequences. Percent of correct implementation of the Precision Request was also recorded. All data were subsequently inspected via visual analysis. The interventionists which participated in the study were unable to implement the Precision Request with fidelity and no effect was found on student compliance, which prompted researchers to examine characteristics of the interventionists as a possible explanation for failure to implement with fidelity. A comparison of interventionists suggests that the Precision Request may be too difficult to implement for an individual who lacks behavioral training, who does not use foundational classroom procedures such as positive reinforcement and verbal praise, and/or whose philosophical viewpoints are not conducive to behavior analysis. Future research should examine contextual fit as regards behavioral interventions and interventionists, as well as which behavioral principles need to be mastered by an interventionist before the Precision Request can be implemented with fidelity.

Parents of children with an autism spectrum disorder experience many stressors in their lives, including managing problem behaviors of their child. Parent training can effectively teach parents strategies to manage noncompliant behaviors; however, many parents spend months on wait lists before accessing this service. This study investigated the preliminary effects of both an expert-led and parent-led training for wait-listed parents. Thirteen parents of children currently on a waitlist to receive behavioral analytic services participated; most were highly educated, all were white and married. The study used a pyramidal training approach: a professional instructed one group of participants while a participant volunteer instructed the second group. Participants completed a training on several behavior management techniques. Training was conducted in a manner plausible for community clinics to implement. Checklists and direct observations of trainee behavior were taken to observe fidelity of training. Data were also collected using parent self-report measures using Likert-scales to report on their own behavior as well as their child’s behavior. Participants from both groups reported decreases in child noncompliant behavior and increases in parent self-efficacy, confidence and consistency in administering behavior management techniques, indicating that both expert-led and parent-led training are effective in decreasing reported noncompliant behavior and increasing parent-reported self-efficacy. Clinics and communities should seek to implement similar programs to address wait-list issues; using a pyramidal parent training module may allow more parents to access information in a more efficient fashion. Further research should be conducted on larger groups and additional levels of pyramidal training.

This research contributes to gaps in the international relations and international law literature on compliance by engaging practitioners with multilateral environmental agreement (MEA) expertise to answer two questions: 1) what factors are associated with MEA noncompliance; and 2) is there a relationship between the design of MEA provisions and compliance with those provisions. Practitioners overwhelmingly associate MEA noncompliance with insufficient domestic interagency consultation early in the lifecycle of a multilateral environmental agreement, particularly during its negotiation. The interagency consultative process is the mechanism by which a state identifies the nature of its relevant domestic environmental challenges and the availability of its institutional, financial, and technical resources to address them. Absent a robust process, state delegated representatives engage in negotiating obligations on behalf of their states without a full understanding of the domestic context. Consequently, they may inadvertently negotiate obligations that are impractical or otherwise inconsistent with domestic realities. Under these circumstances, a state may subsequently set itself on a trajectory of noncompliance when ratifying the agreement. Three noncompliance cases under the Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and Their Disposal are consistent with this finding. The design of treaty provisions might serve to mitigate some factors associated with MEA noncompliance. Practitioners observe a relationship between the design of treaty provisions and compliance with those provisions. When presented with two different legal design options, practitioners overwhelmingly expressed a preference for obligations of outcome over obligations of action. Preserving state flexibility to determine how to implement obligations may mitigate noncompliance associated with insufficient domestic consultation early in the lifecycle of an MEA, but more research is necessary to draw the conclusion that one legal design produces better compliance results over another. / Doctor of Philosophy / States actively negotiate multilateral environmental agreements (MEA) to address transboundary environmental challenges. When states fail to comply with their obligations under these agreements, the international community's collective environmental goals are compromised. This research contributes to the literature on compliance by exploring two questions: 1) what factors are associated with MEA noncompliance; and 2) is there a relationship between the design of MEA provisions and compliance with those provisions. MEA noncompliance is overwhelmingly associated with states' poor preparation to engage in the negotiation and implementation of multilateral environmental agreements. Poor preparation is the result of insufficient domestic interagency consultation, which is the process by which a state identifies the nature of its relevant domestic environmental challenges and its ability to address them. The design of MEA provisions might serve to mitigate some factors associated with noncompliance, particularly if that design gives states the flexibility to later determine how or which domestic measures to take in order to meet the relevant outcome contained in their MEA obligations. However, more research is needed to draw the conclusion that one legal design is better than another.

As doenças crônicas estão entre as que mais crescem no Brasil e ao mesmo tempo apresentam alto índice de não adesão ao tratamento por parte dos pacientes. Apesar do esforço das políticas públicas, junto as campanhas de prevenção, conscientização e acesso aos medicamentos a essa população, a taxa de não adesão é alta. Pode-se dizer que os médicos e profissionais da saúde encontram algo que parece de difícil compreensão a partir do seu discurso: como pensar a ideia de que os pacientes parecem, de modo inusitado, se recusar a aderir ao tratamento? Segundo a Psicanálise, a questão da adesão não é simples: implica a maneira como cada paciente lida com o seu adoecimento. Dessa maneira, o presente trabalho, trata-se de um estudo teórico, com revisão bibliográfica e tem por objetivo propor uma ampliação teórica sobre a compreensão dada a não adesão em doenças crônicas. Nos valemos de conceitos centrais, tais como o inconsciente, a lógica entre demanda e desejo, o sintoma, passando por gozo e ato para compreender a não adesão como uma manifestação do sujeito do inconsciente. São objetivos específicos: a) levantar e percorrer a literatura científica produzida sobre a definição médica de doença crônica, índice de não adesão, fatores de risco para a não adesão e as formas de tratamento oferecidas para esses pacientes nas instituições de saúde. b) ampliar a discussão da não adesão ao tratamento da doença crônica, trazendo a ética da Psicanálise como pilar da atuação do analista nas instituições de saúde para poder propor propostas singulares aos pacientes que levem em conta a escuta do sujeito do inconsciente, c) discutir a importância da manutenção do analista na instituição e da transmissão dos efeitos analíticos como tática de inserir a Psicanálise na discussão das políticas públicas. A posição do analista nas instituições de saúde, se pauta pela impossibilidade de sustentar propostas universais em termos de tratamento que servem para todos. A não adesão a um tratamento significa muito mais do que simplesmente aderir ou não a uma prescrição médica. O avanço teórico e conceitual da não adesão, se faz necessário, pois aderir ao tratamento significa aderir uma nova condição de vida, é poder se apropriar de um corpo doente e não mais saudável como imaginado. Aderir é aceitar limitações e assumir uma queda da posição narcísica com o corpo. Portanto, o desafio que se coloca para o analista é poder propor e sustentar projetos terapêuticos singulares nas instituições á partir do estabelecimento de políticas públicas que levem em conta o sujeito do inconsciente. Uma práxis que não vai garantir a adesão, que não vai prescrever e nem convencer, mas que vai lidar com a dimensão do inconsciente, tão presente nas falas dos pacientes, sem se voltar para uma prática normativa, mas sim para uma escuta na direção do sintoma, da fantasia, do gozo e do ato, ou seja lidar com o sujeito / Chronic diseases are among the highest growing in Brazil and at the same time they present a high rate on noncompliance by the patients. In spite of the efforts of public policies, along with campaigns to raise prevention, awareness and access to medicine in that population, noncompliance rates are high. It can be said that doctors and health professionals encounter something that seems hard to comprehend from their discourse: how to think the idea that patients appear to, in usual fashion, refuse to adhere to treatment? According to Psychoanalysis, the question of adherence isnt simple: it implicates the way in which each patient deals with his illness. Thus, the present work is a theoretical study, with a bibliographical revision and has the objective of proposing a theoretical amplification on the comprehension of noncompliance in chronic diseases. Well use the main concepts, such as the unconscious, the logic between demand and desire, the symptom, as well as jouissance and act to understand noncompliance as a manifestation of the subject of the unconscious. The specific objectives are: a) to raise and travel the scientific literature regarding the medical definition of chronic disease, the rate of noncompliance, risk factors for noncompliance and the treatments offered for these patients at health institutions. b) to amplify the discussion of noncompliance to treatment of the chronic disease, bringing the ethics of Psychoanalysis as a pillar of the practice of the analyst in the health institutions in order to propose unique proposals to the patients that take into consideration the listening of the subject of the unconscious. c) to discuss the importance of the practice and position of the analyst in the institution and the transmission of the analytical effects as a tactic of inserting Psychoanalysis in the discussion of public policies. The position of the analyst in the health institutions is guided by the impossibility of sustaining universal proposals in terms of treatments that serve all. Noncompliance to a treatment means much more than simply adhering or not to a medical prescription. Theoretical and conceptual advances of noncompliance are necessary, for adhering to a treatment means adhering to a new life condition, it is being able to appropriate a body that is sick and no longer healthy as imagined. Adhering is accepting limitations and assuming a fall from the narcissistic position with the body. Therefore, the challenge that is presented for the analyst is to be able to propose and sustain singular therapeutic projects in institutions by the establishment of public policies that take into consideration the subject of the unconscious. A praxis that will not guarantee adhesion, that will not prescribe or convince, but one that will deal with the unconscious dimension, which are so present in the speech of patients, without turning to a normative practice, but to a listening in the direction of the symptom, the fantasy, of jouissance and the act, that is, dealing with the subject of the unconscious

Despite decades of the implementation of the directly observed therapy short-course (DOTS), Sierra Leone is ranked among the 30 highest TB-burdened countries. Several factors account for unfavorable treatment outcomes, among which are patient characteristics. Previous studies have only focused on treatment compliance without any consideration for the factors that lead to noncompliance to treatment. The purpose of this study was to investigate patient characteristics that are associated with treatment noncompliance (treatment not completed) among TB patients undergoing the DOTS program in Sierra Leone. A retrospective longitudinal quantitative design was used to analyze secondary data from the completed records of 1,633 TB patients, using the Andersen's behavioral model of health services utilization as a theoretical framework work. Descriptive statistics and bivariate and multivariate logistic regressions were used to analyze the data. The results show that there was no significant association between treatment completion and age, gender, and TB-case category. On the other hand, being HIV-positive decreases the odds of treatment completion. Also, the educational level, geographic location, and year of treatment were significantly associated with treatment completion. Overall, program performance improved as the number of dropouts decreased significantly between 2013 and 2015. The social change implication of this study was that it identified HIV-positive patients and rural communities as areas needing specific attention such as the assignment of case managers to ensure compliance thereby improve DOTS program performance, thereby reducing the incidence and transmission of TB

Addressing climate change is a major undertaking. Agricultural soil has the potential to assist in decreasing the concentration of GHGs in the atmosphere by storing CO2 in the soil. Carbon offset markets have been suggested as a cost effective means of reducing GHG emissions. Farmers can increase their soil sink potential by applying Beneficial Management Practices (BMPs) that enhance carbon sequestration through improvements to soil, nutrient and livestock management practices (Fulton et. al., 2005). Whether or not a market for carbon offsets will emerge depends on a number of factors which mainly are related to the profitability of the BMPs and the costs of implementing a carbon contract. Provided that a market for carbon offsets emerges, the effectiveness of the market depends, in part, on the degree to which buyers and sellers in the market comply with the terms of the contracts they sign. The resource costs associated with monitoring and verification may result in incomplete monitoring. As long as monitoring is not perfect, non-compliance will be an issue. <p>The analysis that will be performed in this thesis introduces non-compliance in the economic analysis of carbon-offset market. The purpose of this work is to examine the overall cost effectiveness of the carbon-offset market when introducing non-compliance. <p>Firstly the theoretical model investigates the incentives for different farmers to participate in the carbon offsets market as well as incentives for engaging in cheating. The model recognizes farmers heterogeneity with respect to cost differences and examines the economic determinants of farmers non-compliance as well as the consequences of non-compliance on the performance of the carbon-offset market. Results support the standard finding that the extent of producers non-compliance decreases with an increase in the audit probability and/or an increase in the penalty per unit of non-compliance. In addition, the number of producers participating in the carbon offsets market is shown to increase with an increase in the carbon-offset price.<p> The analysis then introduces intermediaries in the market that will take care of trading carbon offsets as well as monitoring producers. The traders role in this study is played by an IOF (investor owned-firm) or a PA (producers association). Within the IOF, the analysis focuses on the monopoly and oligopoly structures. The key role of the traders is to guarantee, based on the amount of monitoring that is undertaken, that the emitters purchase only carbon offsets that actually correspond to sequestered carbon. The analysis then examines three cases for the group that monitors farmers compliance a group owned by for-profit traders, a government-run agency and a group owned by the PA trader. This part of the thesis examines what impact the involvement of the traders in the carbon-offset market has on non-compliance, as well as how the structure of the monitoring group affects non-compliance and the amount of carbon offsets traded in the market. The results of the analysis show that the monitoring groups always undertake sufficient monitoring to ensure that full compliance is achieved thus, while non-compliance is possible, it does not occur in equilibrium. The finding suggests that the formation of a government monitoring agency can potentially increase traded output and lower the price paid by emitters, still these changes are likely to be small, particularly when the trading sector is monopolistic. The overall analysis in this chapter shows that the optimal amount of enforcement, and as a result the cost effectiveness of a carbon-offset market, depends on the nature of the organization that undertakes the enforcement. <p>The next consideration of the thesis is the heterogeneity attributed to the timing of sequestration by different farmers. The analysis focuses on the carbon offsets pooling by considering two structures for the aggregator: a for-profit aggregator and a producers association. Pooling resources enables the farmers to benefit from economies of scale. The pricing schedule used by the aggregator is a two-part tariff. The two-part tariff is used as a way of providing an incentive for the farmers sequestering large amounts of carbon to participate in the pool. The study considers two alternatives for the coefficients that might be used to decide on the amount of carbon offsets to which each farmer will be entitled: default coefficient and custom coefficients. Each situation is modeled in a principal agent framework. <p>The analysis examines how the aggregator will target the monitoring service for different group of farmers. The investigation reveals that, under different scenarios, a PA or a FPA (for-profit aggregator) might lead to the formation of a heterogeneous pool or a homogeneous pool of each type. <p>The last issue investigated in this dissertation is the coexistence of a FPA and a PA in the default coefficient case. The analysis show that both aggregator structures can exist together in the market in the same time if the savings in the monitoring costs made possible by the PA are smaller than the cost of organizing the pool. If this condition is not satisfied the FPA cannot survive in the market and the producers association will dominate. <p>In addition to providing a better understanding of how the carbon-offset market may perform when introducing non-compliance, the results of this study can assist in assessing the cost effectiveness of the carbon-offset market when enforcement is undertaken by different organizations. Furthermore, the last consideration of the pooling option might help in selecting which type of pool a heterogeneous or a homogeneous one might perform better under different alternatives.

Addressing climate change is a major undertaking. Agricultural soil has the potential to assist in decreasing the concentration of GHGs in the atmosphere by storing CO2 in the soil. Carbon offset markets have been suggested as a cost effective means of reducing GHG emissions. Farmers can increase their soil sink potential by applying Beneficial Management Practices (BMPs) that enhance carbon sequestration through improvements to soil, nutrient and livestock management practices (Fulton et. al., 2005). Whether or not a market for carbon offsets will emerge depends on a number of factors which mainly are related to the profitability of the BMPs and the costs of implementing a carbon contract. Provided that a market for carbon offsets emerges, the effectiveness of the market depends, in part, on the degree to which buyers and sellers in the market comply with the terms of the contracts they sign. The resource costs associated with monitoring and verification may result in incomplete monitoring. As long as monitoring is not perfect, non-compliance will be an issue. <p>The analysis that will be performed in this thesis introduces non-compliance in the economic analysis of carbon-offset market. The purpose of this work is to examine the overall cost effectiveness of the carbon-offset market when introducing non-compliance. <p>Firstly the theoretical model investigates the incentives for different farmers to participate in the carbon offsets market as well as incentives for engaging in cheating. The model recognizes farmers heterogeneity with respect to cost differences and examines the economic determinants of farmers non-compliance as well as the consequences of non-compliance on the performance of the carbon-offset market. Results support the standard finding that the extent of producers non-compliance decreases with an increase in the audit probability and/or an increase in the penalty per unit of non-compliance. In addition, the number of producers participating in the carbon offsets market is shown to increase with an increase in the carbon-offset price.<p> The analysis then introduces intermediaries in the market that will take care of trading carbon offsets as well as monitoring producers. The traders role in this study is played by an IOF (investor owned-firm) or a PA (producers association). Within the IOF, the analysis focuses on the monopoly and oligopoly structures. The key role of the traders is to guarantee, based on the amount of monitoring that is undertaken, that the emitters purchase only carbon offsets that actually correspond to sequestered carbon. The analysis then examines three cases for the group that monitors farmers compliance a group owned by for-profit traders, a government-run agency and a group owned by the PA trader. This part of the thesis examines what impact the involvement of the traders in the carbon-offset market has on non-compliance, as well as how the structure of the monitoring group affects non-compliance and the amount of carbon offsets traded in the market. The results of the analysis show that the monitoring groups always undertake sufficient monitoring to ensure that full compliance is achieved thus, while non-compliance is possible, it does not occur in equilibrium. The finding suggests that the formation of a government monitoring agency can potentially increase traded output and lower the price paid by emitters, still these changes are likely to be small, particularly when the trading sector is monopolistic. The overall analysis in this chapter shows that the optimal amount of enforcement, and as a result the cost effectiveness of a carbon-offset market, depends on the nature of the organization that undertakes the enforcement. <p>The next consideration of the thesis is the heterogeneity attributed to the timing of sequestration by different farmers. The analysis focuses on the carbon offsets pooling by considering two structures for the aggregator: a for-profit aggregator and a producers association. Pooling resources enables the farmers to benefit from economies of scale. The pricing schedule used by the aggregator is a two-part tariff. The two-part tariff is used as a way of providing an incentive for the farmers sequestering large amounts of carbon to participate in the pool. The study considers two alternatives for the coefficients that might be used to decide on the amount of carbon offsets to which each farmer will be entitled: default coefficient and custom coefficients. Each situation is modeled in a principal agent framework. <p>The analysis examines how the aggregator will target the monitoring service for different group of farmers. The investigation reveals that, under different scenarios, a PA or a FPA (for-profit aggregator) might lead to the formation of a heterogeneous pool or a homogeneous pool of each type. <p>The last issue investigated in this dissertation is the coexistence of a FPA and a PA in the default coefficient case. The analysis show that both aggregator structures can exist together in the market in the same time if the savings in the monitoring costs made possible by the PA are smaller than the cost of organizing the pool. If this condition is not satisfied the FPA cannot survive in the market and the producers association will dominate. <p>In addition to providing a better understanding of how the carbon-offset market may perform when introducing non-compliance, the results of this study can assist in assessing the cost effectiveness of the carbon-offset market when enforcement is undertaken by different organizations. Furthermore, the last consideration of the pooling option might help in selecting which type of pool a heterogeneous or a homogeneous one might perform better under different alternatives.

We examine three topics related to experimental design in this dissertation. Two are related to the analysis of experimental data and the other focuses on the design of paired comparison experiments, in this case knockout tournaments. The two analysis topics are motivated by how to estimate and test causal effects when the assignment mechanism fails to create balanced treatment groups. In Chapter 2, we apply conditional randomization tests to experiments where, through random chance, the treatment groups differ in their covariate distributions. In Chapter 4, we apply principal stratification to factorial experiments where the subjects fail to comply with their assigned treatment. The sources of imbalance differ, but, in both cases, ignoring the imbalance can lead to incorrect conclusions. In Chapter 3, we consider designing knockout tournaments to maximize different objectives given a prior distribution on the strengths of the players. These objectives include maximizing the probability the best player wins the tournament. Our emphasis on balance in the other two chapters comes from a desire to create a fair comparison between treatments. However, in this case, the design uses the prior information to intentionally bias the tournament in favor of the better players. / Statistics