Children with Down syndrome often have high body mass index scores, brought on by hypothyroidism, poor mastication, decreased metabolic rates, and inconsistent physical fitness routines. Along with various genotypic characteristics, several behavioral tendencies accompany the diagnosis of Down syndrome. People with this condition often engage in noncompliant behaviors in an attempt to escape work-related tasks such as exercising. A lack of a consistent fitness regimen may result in additional health complications for this particular group of people, as well as ensuing concerns from the parents or guardians who care for them. Because of the propensities for poor physical health in people with Down syndrome, it is imperative that this group of people include exercise-related activities in their health-care routines to help promote a positive well-being from childhood to adulthood.The purpose of this study is to report on the results of an intervention which utilized high-probability tasks and principles of generalization to address noncompliant behaviors in a 9-year-old boy who had Down syndrome and a history of engaging in refusal towards exercise-related activities. Gross motor skills adapted from the Test of Gross Motor Development assessment were used throughout the study to evaluate both compliance and accuracy of the pre-selected movements. This study used a changing conditions design to assess John’s growth throughout 5 distinct phases. Results from both the high-probability tasks and generalization interventions showed an overall increase in the participant’s compliance and accuracy of skill development throughout all stages of the experiment. Implications from this study provide positive support for using antecedent-based interventions to help individuals with Down syndrome engage in exercise-related activities.

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Abstract Many studies explore how firm-level characteristics affect the returns that corporate insiders earn when they trade the stocks of their own firms, but little is known about the role of insiders’ personal characteristics. This dissertation contributes to the literature by expanding our understanding of how corporate insiders’ personal characteristics affect their decisions to exploit private information in insider trading. The first essay of the dissertation examines whether insiders who have shown noncompliance with the tax law are more prone to exploit their information advantage in insider trading than other insiders. Our empirical results from analyzing archival data of all insider trades in Sweden show that the noncompliant insiders use more of their information advantage to trade their insider stocks shortly before significant stock price changes than other insiders. The second essay explores why insiders engage in informed insider trading, given the surprisingly small average insider returns reported in the literature and the potential costs involved. Using archival data of corporate insiders in Sweden, we show that less wealthy insiders are more likely to time their insider selling, and sell in greater magnitudes, prior to abnormal price declines than wealthy insiders. We also find that less-wealthy insiders with lower risk-aversion as measured by their criminal behavior are particularly prone to timing their selling to avoid price declines. The third essay examines what type of insiders are willing to violate their own company’s restrictions on insider trading by trading on their private information during blackout periods when the firm prohibits trading by its insiders. Using archival data of corporate insiders in Finland, I find that less-wealthy insiders avoid economically significant insider losses by selling their insider stocks during the prohibited blackout period. These insider sales also predict negative earnings surprises. / Tiivistelmä Tämä väitöskirja laajentaa aikaisempaa tutkimuskirjallisuutta tarkastelemalla, miten yritysten sisäpiiriläisten henkilökohtaiset ominaisuudet vaikuttavat sisäpiirin kaupankäynnin tuottoihin. Väitöskirjan ensimmäisessä osatutkimuksessa tutkitaan, voidaanko sisäpiirin kaupankäynnin tuottoja selittää sisäpiiriläisten verottajalta saamien hallinnollisten sanktioiden avulla. Osatutkimuksen empiiristen tulosten mukaan verottajalta hallinnollisia sanktioita saaneet sisäpiiriläiset ansaitsevat merkittävästi suurempia sisäpiirin kaupankäynnin tuottoja kuin muut sisäpiiriläiset. Aikaisemmissa tutkimuksissa havaitut sisäpiirin kaupankäynnin tuotot vaikuttavat verrattain pieniltä, kun huomioidaan sisäpiiritiedon hyödyntämiseen liittyvä maine- ja juridinen riski. Toisessa osatutkimuksessa tutkitaan, miksi jotkut sisäpiiriläiset kuitenkin päättävät hyödyntää sisäpiiritietoaan käydessään kauppaa yhtiöidensä osakkeilla. Tulosten mukaan matalamman varallisuuden sisäpiiriläiset ajoittavat osakemyyntinsä todennäköisemmin ennen osakekurssien laskuja kuin korkeamman varallisuuden sisäpiiriläiset. Tämä tulos on erityisen vahva sellaisten matalamman varallisuuden sisäpiiriläisten joukossa, jotka ovat erityisen riskihakuisia henkilökohtaisilla rikostuomioilla mitattuna. Väitöskirjan kolmannessa osatutkimuksessa tutkitaan, millaiset sisäpiiriläiset eivät noudata yhtiöidensä asettamia rajoituksia sisäpiirin kaupankäynnille vaan hyödyntävät sisäpiiritietoaan käymällä kauppaa ns. suljetun ikkunan aikana, jolloin yhtiön asettamat rajoitukset kieltävät sisäpiirin kaupankäynnin. Tämän osatutkimuksen empiirisen tulosten mukaan matalamman varallisuuden sisäpiiriläiset ansaitsevat suljetun ikkunan aikana toteuttamillaan osakemyynneillä merkittävästi suurempia tuottoja kuin muut sisäpiiriläiset. Matalamman varallisuuden sisäpiiriläisten suljetun ikkunan aikana toteuttamat osakemyynnit myös ennustavat yrityksen julkistamaa tulevaa negatiivista tulosyllätystä.

Submitted by Marlene Aparecida de Souza Cardozo (mcardozo@pucsp.br) on 2016-08-27T17:44:20Z No. of bitstreams: 1 Candice Buckley Bittencourt Silva.pdf: 1101690 bytes, checksum: 2e02ddadee7b8a9a42a6fdf9629d9090 (MD5) / Made available in DSpace on 2016-08-27T17:44:20Z (GMT). No. of bitstreams: 1 Candice Buckley Bittencourt Silva.pdf: 1101690 bytes, checksum: 2e02ddadee7b8a9a42a6fdf9629d9090 (MD5) Previous issue date: 2016-06-07 / Law #11.101/2005 introduced in Brazilian legal system an unprecedented feature, that of the judicial reorganization, nowadays widely utilized and consolidated into case law and doctrine, as well as in legal practice. However, some other aspects and features contemplated in the 10-year plus piece of legislation still haunt those who come across them, creating doubts and uncertainties. One of these cases is that of the decision which grants the judicial reorganization, foreseen in article 58, caput, of Law # 11.101/2005, and handed down at the peek of a lawsuit that involves, amongst other acts, the summoning of creditors, the debate between them and the debtor, the presentation of a judicial reorganization plan and its discussion by the creditors gathered at a creditors’ meeting. Such decision is the culminating point of the procedure foreseen in Law # 11.101/2005, starting the moment the debtor decides to resort to judicial reorganization’s legal aid. This work examines the nature of the decision that grants the judicial reorganization, as defined by Law # 11.101/2005, its intrinsic characteristics, its content, effects and outcomes triggered by potential noncompliance of the reorganization plan by the debtor, and the effectiveness of the decision as an execution title, in view of the peculiarities inherent to the judicial reorganization proceeding / A Lei 11.101/2005 introduziu no ordenamento jurídico brasileiro o instituto da recuperação judicial, hoje amplamente utilizado e consolidado, tanto na doutrina e jurisprudência quanto na prática forense. No entanto, alguns outros aspectos e institutos contemplados na legislação que completou uma década em 2015 ainda assombram os que com eles se deparam, gerando dúvidas e incertezas. Um desses casos é o da decisão que concede a recuperação judicial, prevista no artigo 58, caput, da Lei 11.101/2005, e proferida ao cabo de um processo que envolve, entre outros atos, a convocação dos credores, o debate entre esses e o devedor, a apresentação de um plano de recuperação judicial e a deliberação dos credores reunidos em assembleia sobre o plano apresentado. Trata tal decisão do ponto culminante de todo o procedimento previsto na Lei 11.101/2005 a partir do momento em que o devedor decide recorrer ao auxílio legal da recuperação judicial. Este trabalho examina a natureza da decisão de concessão da recuperação judicial, conforme definida pela Lei 11.101/2005, suas características intrínsecas, seu conteúdo, seus efeitos, e os desdobramentos decorrentes do eventual não cumprimento do plano de recuperação judicial pela empresa devedora, e a efetiva exigibilidade da sentença de concessão como título executivo, diante das peculiaridades inerentes ao processo de recuperação judicial

No-show appointments, also referred to as missed appointments, occur 23% to 34% annually in general practice care settings. Missed appointments can lead to reduction in appointment availability, decrease in provider/staff productivity, patient/provider discordance, disruption in continuity of care, and reduced quality of care. There is a gap in the nursing literature regarding effective interventions to reduce missed appointments. The purpose of this quality improvement, secondary analysis project was to determine whether implementation of an evidence-based no-show, nurse-led intervention would reduce missed appointment rates in a family medicine practice. The health belief model and the plan, do, study, act model guided this no-show project. Convenience sampled, password-secured quantitative data from nurse practitioner schedules were analyzed using a check-sheet tool and spreadsheet software. Data showed that after implementation of the evidence-based, nurse-led interventions, there was a reduction of no-shows with a decline from 23.5% in September and November 2017 to 17% in September and November 2018. Results of this no-show project might promote positive social change by increasing awareness of evidence-based interventions that are effective for reducing missed appointments in primary care practices.

Seat belts save lives; however, unintentional injuries are still the leading cause of death for those between 1 and 44 years in the United States. Seat belts also cause injuries during motor vehicle crashes (MVCs) and obesity changes how seat belts fit. The purpose of this retrospective causal inference quantitative study was to reduce the knowledge gap in scholarly research on seat belt fit in relation to blunt cerebrovascular injuries (BCVI) during MVCs and seat belt compliance. The theoretical framework used was based on H.W. Heinrich's domino theory. The research questions focused on the following dependent variables: BCVI, compliance, and seat belt fit; and independent variables: the size of the individual and seat belt fit. Secondary and primary data were used and analyzed using Spearman's Rank-Order Correlation. The results yielded no relationship between seat belt fit and BCVI in the secondary data (n = 97). In the primary data (n = 138), there was significance found between seatbelt fit and a) seat belt use, and b) BMI. The study contributed to positive social change by enhancing the awareness of the knowledge deficit regarding seat belt fit, and BCVIs sustained during MVCs, and that comfort was influenced by seat belt fit and had a role in compliance. Seat belts were not used by 5.3% and 9.5% or used incorrectly by 3.2% and 2.9% of the people in the primary data and secondary data sets. This knowledge may contribute to a) future seat belt testing to ensure it is done in such a manner that seat belts fit everyone; b) new seat belt laws to ensure that they are consistent across all states, and c) medical care focusing on seat belt fit as a mechanism of injury (blunt) to ensure screenings are done with the appropriate diagnostic tools.

Estimating causal effects in clinical trials is often complicated by treatment noncompliance and missing outcomes. In time-to-event studies, estimation is further complicated by censoring. Censoring is a type of missing outcome, the mechanism of which may be non-ignorable. While new estimates have recently been proposed to account for noncompliance and missing outcomes, few studies have specifically considered time-to-event outcomes, where even the intention-to-treat (ITT) estimator is potentially biased for estimating causal effects of assigned treatment. In this thesis, we develop a series of parametric potential-outcome (PPO) survival models, for the analysis of randomised controlled trials (RCT) with time-to-event outcomes and noncompliance. Both ignorable and non-ignorable censoring mechanisms are considered. We approach model-fitting from a likelihood-based perspective, using the EM algorithm to locate maximum likelihood estimators. We are not aware of any previous work that addresses these complications jointly. In addition, we give new formulations for the average causal effect (ACE) and the complier average causal effect (CACE) to suit survival analysis. To illustrate the likelihood-based method proposed in this thesis, the HIP breast cancer trial data \citep{Baker98, Shapiro88} were re-analysed using specific PPO-survival models, the Weibull and log-normal based PPO-survival models, which assume that the failure time and censored time distributions both follow Weibull or log-normal distributions. Furthermore, an extended PPO-survival model is also derived in this thesis, which permits investigation into the impact of causal effect after accommodating certain pre-treatment covariates. This is an important contribution to the potential outcomes, survival and RCT literature. For comparison, the Frangakis-Rubin (F-R) model \citep{Frangakis99} is also applied to the HIP breast cancer trial data. To date, the F-R model has not yet been applied to any time-to-event data in the literature.

Objective: Treatment compliance in children with Crohn’s disease is associated with higher levels of symptom remission. We hypothesized that the management, comorbidities, and complications for children with Crohn’s disease would differ based on a diagnosis of noncompliance. Methods: Using the Kids’ Inpatient Database for 2006-2012, we identified young patients (<21 >years) with a diagnosis of Crohn’s disease. Diagnoses and procedures were analyzed according to a recorded diagnosis of noncompliance. Multivariable logistic regression analysis was performed to examine the association between noncompliance and the outcomes of interest. Results: There were 28,337 pediatric Crohn’s disease hospitalizations identified with 1,028 (3.6%) hospitalizations having a diagnosis of both Crohn’s disease and noncompliance. The mean age of the study population was 15.9 years and 48.9% were girls. Black patients ( multivariable adjusted odds ratio, aOR,2.27; 95% CI:1.84-2.79) and those in the lowest income quartile (aOR 1.57; 95% CI:1.20-2.05) had an increased likelihood of a noncompliance diagnosis than respective comparison groups. Noncompliant patients had an increased likelihood of concurrent depression, nutritional deficiency, and anemia. Patients with a diagnosis of noncompliance had lower rates of intestinal obstruction (4.0% vs 6.3%), intraabdominal abscesses (2.0% vs 4.2%,), and underwent fewer major surgical procedures (aOR 0.40; 95% CI:0.31-0.53) and large bowel resections (aOR 0.44; 95% CI:0.31-0.64) than patients without this diagnosis. Conclusions: We found significant differences in socioeconomic status and race among hospitalized children with Crohn’s disease with, as compared to those without, a diagnosis of noncompliance. Children with noncompliance have different comorbidities, disease-related complications, and are managed differently. Possible explanations for observed treatment differences include a reluctance to offer surgery to those with a diagnosis of noncompliance, a refusal of intervention by noncompliant patients, or implicit bias. Further investigation is warranted to better define noncompliance in this population and to determine the implications of this diagnosis.

This thesis studies inference to the complier treatment effect denoted LATE. The standard approach is to base the inference on the two-stage least squares (2SLS) estimator and asymptotic Neyman inference, i.e., the t-test. The paper suggests a Fisher Randomization Test based on the t-test statistic as an alternative to the Neyman inference. Based on the setup with a randomized experiment with noncompliance, for which one can identify the LATE, I compare the two approaches in a Monte Carlo (MC) simulations. The results from the MC simulation is that the Fisher randomization test is not a valid alternative to the Neyman’s test as it has too low power.

No description available.