Magister Curationis / A problem was identified at Aid for AIDS (AfA) whereby some doctors requested a change in treatment within less than a year after their patients started antiretroviral therapy. The requests were normally based on treatment failure. It appears that in most cases where the desired treatment outcome is not achieved is due to poor adherence to therapy. AfA is a HIV / AIDS disease management company offering access to antiretroviral therapy (ART), prevention of opportunistic infections, treatment and blood results monitoring, treatment support through adherence coordinators and expert clinical support and advice to healthcare providers. They monitor treatment adherence through claims history, CD4 and viral load (VL) results as well as telephonic contact with the client. Factors that could contribute to poor adherence are side - effects, barriers e.g. work environment, non - disclosure, lifestyle, lack of client commitment, limited contact between the client and treatment support counsellor, limited funds, stigmatisation and a lack of clear adherence guidelines to improve treatment outcome. Method: A comparative study was done to assess the impact of an intervention to improve patient adherence to ART. The researcher postulates that by the implementation of guidelines to counsellors, client adherence to therapy would increase. A comparative study was used to assess whether structured guidelines can improve client adherence to therapy. Results: The results have proven that guidelines used by treatment support counsellors does improve adherence to ART. Recommendations: It is recommended that treatment support counsellors, to improve their clients’ adherence to ART, should apply adherence guidelines. / South Africa

Compliance, the extent to which patients follow a medication regimen, has been recognized as one of the most serious problems facing medical practice today. Recent developments in assessing compliance include electronic compliance monitors (ECM), devices that record the date and time of the release of medication from its original container. This allows utilizing ECM compliance data in statistical analyses related to clinical trials. This thesis proposes ways of dealing with the time-varying nature of compliance. We examine the compliance behaviour from real ECM data through statistical analysis of compliance rate, followed by a time-to-event analysis with respect to first noncompliance event. Then, using discrete event simulation and proportional hazards models we compare analyses using a fixed treatment covariate and time-varying compliance covariate based on pharmacokinetic principles in estimating treatment effect. We observe a reduction of up to 40% in EMSE in favour of the latter model for treatment effect estimation.

Theses in the theoretical part deals with risk management and its concrete form in the banking sector. Closer it is aimed at an area of the implementation of measures against money laundering and terrorist financing (AML). The main task of AML consists in compliance with the legislative framework of the country where the bank operates. In the context of this regulation shall the bank obtain and keep information on a range of clients. The project, which is addressed in practical patr of the theses, is aimed at improving the system of collection and storage of data on clients in co-organization of J&T BANKA. The project is a computerized database application in MS Access, which allows bank staff to work efficiently with information on clients.

Failure to comply with prescribed regimens is a major reason for the failure of treatment programs. This study investigated factors which are related to compliance with prescribed diet revision therapy for food allergies in school-aged children. Forty-five children, aged 6 to 12 years, who were under a physician's care for food allergies, formed the sample. The Health Belief Model was used as the basis for a questionnaire devised to measure these factors. The development of the Diet Revision Therapy Parent Questionnaire involved a pilot test and revisions; the resulting instrument consists of 38 items organized into 4 subtests, of which one 7-item subtest is to be considered optional. The 38-item DRTPQ has a full scale internal consistency reliability of .87, and a composite reliability of .61 for the four subscales. The canonical correlation between 3 types of subjective ratings of compliance and the 4 subtests is .80, with 64% shared variance between these sets of variables. A discriminant function of 3 subtests of the DRTPQ proved capable of discriminating diet therapy dropouts from continuing subjects with 88.9% accuracy. These three subtests measured: 1. Parent and family life factors, such as the amount of perceived interference in normal routines, 2. Child's attitudes to the treatment and his/her normal behavior with respect to cooperation with parental demands, and 3. Belief in the benefits to be derived from the treatment. A fourth category of items measured perceived severity of the condition and perceived susceptibility to illness but proved not to predict compliance in this sample, although it may be useful in clinical practice. Suggestions for interventions to aid compliance are outlined. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Social support has been associated with reduced mortality and morbidity from a number of causes. To assess possible mechanisms of action relating to cardiovascular (CV) responsiveness, 90 male and female university students delivered a five-minute speech on a controversial topic to a same-sex laboratory confederate. Subjects were randomly assigned to one of three conditions in which the confederate either (a) agreed with the subject, (b) remained impassive (neutral), or (c) disagreed with the subject. Blood pressure (SBP and DBP) and heart rate (HR.) were monitored throughout the experiment. Self-report measures of state self-esteem and affective state were taken pre- and post-task, and reactions to the task were assessed with post-task self-report measures. Subjects reported strong differences in supportiveness of the confederate in the three conditions. Self-report data indicated increase in arousal during the speech (a finding synchronous with CV data), and they reported the Disagree condition to be less pleasant than the Agree condition. CV data were analyzed as a 2 x 3 (sex by experimental condition) repeated measures ANOVA assessing changes from baseline to speech task. Sex differences on CV measures matched patterns generally reported: Men had higher SBP and lower HR than women. All CV measures increased significantly and substantially during the speech task. HR was higher in the Disagree and Neutral conditions than in the Agree condition. SBP and DBP did not differ by condition. There were no sex by condition interactions; however, there was a trend towards men’s HR increasing more in the neutral condition and women’ more in the disagree condition. These data partially support earlier findings in similar experiments while suggesting that subtleties of context, task selection, and content of supportive interaction may have significant impact on the degree to which social support attenuates CV response to social stressors. Unanswered questions for future research are delineated, and implications for designing and implementing interventions that enhance social support are discussed. / Arts, Faculty of / Psychology, Department of / Graduate

The control of communicable diseases in children is an important public health role. With the availability of effective vaccines, the conquest of many childhood diseases is possible. However, the success of the present immunization programs rests ultimately with the parents, who are responsible for ensuring that their children's immunization status is complete. Many factors can influence this parental compliance. The parents of kindergarten students in two suburban communities completed a questionnaire on immunizations and family characteristics. The questionnaire was constructed using items submitted from a panel of public health nurses and from the literature. A pretest was conducted.. The total' number of questionnaires returned by the deadline was 376. Data on preschool children's immunization status were also collected from health unit records. Analyses of the data included frequency distributions, contingency table analyses, factor analysis, and discriminant analysis. The major findings of the study were: 1. There was a difference between preschool children's recorded immunization status according to health unit statistics and the national standard. 2. There was a discrepancy between preschool children's immunization status as reported by parents and as recorded in health unit statistics. There was not a significant relationship between parental education level, family mobility, family socio-economic level, family composition, or parental knowledge of immunizations and preschool children's reported immunization status. 4. There was a significant relationship between a positive parental attitude toward immunization and completed preschool children's reported immunization status. 5. There was a significant relationship amongst the variables. High family mobility, a low educational level for the father, an incomplete parental immunization status, and a feeling of lack of knowledge about immunizations were discriminatory for a reported incomplete immunization status. As well mobility, education-income, family composition and attitude best accounted for the relationship amongst the variables on factor analysis Implications for nursing practise are discussed and recommendations for further research are suggested. / Applied Science, Faculty of / Nursing, School of / Graduate

Two studies were performed to provide insight into the causes and effects of client noncompliance to behavioral treatments. An Analogue Study was performed in which undergraduate participants were taught about progressive muscle relaxation. Participants were randomly assigned to either a directive condition (which placed an emphasis on describing relaxation as an expert would) or a supportive condition (which emphasized incorporating relaxation into the person's daily life). Results indicated that participants in the supportive condition reported higher levels of enjoyment, satisfaction, and homework compliance than participants in the directive condition, but did not display significantly different levels of intrasession noncompliance. As well, a Clinical Study served as a naturalistic study involving six therapist-mother pairs where the mother was presenting with parenting difficulty and worked with the therapist during six sessions of behavioral parent training. This study surprisingly found that mothers were more likely to show noncompliance immediately following therapist supportive behavior than after directive behavior, but that overall levels of directive behavior resulted in less homework completion, and that overall levels of supportive therapist behavior corresponded with higher client satisfaction and lower overall levels of intra-session noncompliance. As well, therapists were more likely to respond to client noncompliance with supportive rather than directive behavior. Reconciliation of these results with previous research was discussed, along with limitations to these studies and potential areas for future research. / Arts, Faculty of / Psychology, Department of / Graduate

Customer compliance has become a pivotal consideration in the marketing strategies of lifestyle management programmes. Previous research has shown that the better customers comply with the directives of service providers, the higher their levels of customer satisfaction (Dellande, 1999). There are numerous lifestyle management programmes available on the market today. Many of these programmes have been linked to the usage of a nutritional product range as a pre-requisite for entering the programme. The investigation of customer compliance in lifestyle management programmes is very important because many of the major societal problems of today, such as high-fat diets, poor physical fitness, substance abuse and smoking, exist because people make poor health choices. Most of the leading causes of death could be reduced substantially if people at risk change five behaviours, namely non-compliance with beneficial health behaviours, poor diet, lack of exercise, smoking and alcohol and drug abuse. The many societal ills related to non-compliance with the aforementioned five behaviours and the dearth of knowledge about the determinants of customer compliance were the main motivations for this study. Another important goal, underlying the motivation for this study, was to understand the relationship between role clarity, role ability, motivation, customer satisfaction and goal attainment. Motivation, which for the purpose of this study has been divided into intrinsic and extrinsic motivation, proved to be the strongest predictor of customer compliance. An online self-administered questionnaire was used to gather quantitative data from 155 respondents who have successfully completed a lifestyle management programme. The results of the first regression model indicated that two of the four independent variables, namely “customers’ role ability” and “intrinsic motivation”, are statistically significant, positive predictors of the dependent variable “customer compliance”. The other two independent variables, “customer role clarity” and “extrinsic motivation”, are not statistically significant predictors of “customer compliance”. The results of the second regression model indicated that “customer compliance” and “customer goal attainment” are statistically significant positive predictors of the dependent variable “customer satisfaction” The most important construct of the study, highlighted in Chapter 6 as well as in the study by Dellande (1999), is customer motivation. If a customer is not motivated, compliance levels will not be sufficient to generate high levels of customer satisfaction. Customer motivation was divided into extrinsic motivation and intrinsic motivation with intrinsic motivation proving to have a stronger correlation with customer compliance than extrinsic motivation. The study was conducted across three different organisations. Research has also suggested that more than half of the customers who commence with a lifestyle management programme never complete the programme or revert to the original lifestyle they followed prior to commencement of the programme. This could have a negative effect on their satisfaction levels. It is, therefore, imperative to ensure that all customers who join a lifestyle management programme are motivated and are able to comply with the directives of the programme to ensure the successful completion thereof. / Dissertation (MCom)--University of Pretoria, 2012. / Marketing Management / MCom / Unrestricted

BAKGRUND: Det kan vara överväldigande att bli diagnostiserad med och leva med en kronisk sjukdom. För många ungdomar påverkas vardagen mycket och innebär även familjen påverkas. Diabetes typ 1 är en allvarlig sjukdom som kräver regelbundna blodsocker-kontroller, insulinadministrering flera gånger dagligen och särskild kost och regelbunden motion. Compliance är en term som används för att beskriva hur väl en patient följer behandlingsrekommendation samt råd vilket är särskilt utmanande för ungdomar. SYFTE: Syftet med studien var att beskriva vilka aspekter som påverkar compliance hos ungdomar med diabetes typ 1. METOD: En litteraturöversikt genomfördes baserad på 12 vetenskapliga artiklar med både kvantitativ och kvalitativ ansats. RESULTAT: Efter granskning och analys av de valda artiklarna presenterades två huvudkategorier: Aspekter som minskar compliance och Aspekter som ökar compliance. Huvudkategorierna har tre underkategorier var. SLUTSATS: Som ungdom, med diagnosen diabetes typ 1, finns det flera aspekter som påverkar compliance. Behandlingen är komplex samt består av flera delar vilket är särskilt utmanande för ungdomar som genomgår en utvecklingsfas. Denna allmänna litteraturstudie visar på att familjen har störst påverkan på ungdomars compliance samt utgör en central och viktig roll i sina barns liv.

This thesis provides a brief intro to the peg-and-hole problem and goes through two active and passive compliance strategies as well as the cases that the compliance center position is not ideal. A specific scenario of peg being gripped at an error angle due to large vision uncertainties is raised and studied. Such setup can lead to an off compliance center position relative to the peg and can happen in real life but has not been solved by previous approaches. A potential solution to it by combining active control and passive compliance is provided and analyzed. By using the force and torque feedback and the robot joint angle information, the compliance center for the above scenario could be estimated without vision feedback to by-pass the potential accuracy limitation of vision sensors. And a position control with reference determined in real-time by these sensors would be able to cancel out the majority of the effect caused by an off compliance center. Additional recommendations to future work on integration of active and passive compliance strategies and utilization of arbitrary compliance center positions are provided as well.