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This dissertation examines inspector discretion and industry compliance in the street-level implementation of building codes. In particular, this study examines the effects that agency-level, individual-level, and environmental variables have on the choice of inspectors to exercise discretion. Unique to this study is the examination of policy congruence between building departments and street-level inspectors as a predictor of industry compliance with regulatory policy. In addition, the various effects of building department enforcement philosophies, departmental capacity for enforced compliance, and environmental variables are considered. The findings indicate that regulatory policy implementation and impact are complex phenomena. There is no single, best predictor for determining what influences inspector behavior and industry compliance. Rather, this study shows that it is a multiplicity of factors, in concert, that shape regulatory outputs and outcomes. From this dissertation we can learn lessons that can be applied to other policy areas to create a better understanding of inspector discretion, improve industry compliance with regulations, and achieve more effective street-level implementation and understanding of policy impact.

Glaucom, one of the most significant opthamology problems, is the second most often reason of blindness.Conservative treatment is frequently used for the treatment.Currently in Czech Republic, the local applied preparates share more than 50 % of the total cost of all opthamopharmaceutics. Generally, the efficiency much depends on a patient compliance. A patient collaboration is very problematical mainly at chronic illness. The patient does not observe necessarily symptoms of illness. The aim of the diploma work is an assesment of an impact of non-compliance phenomenon (mainly at patient side) on antiglaukopharmaceutics and analysis of development of prescription of antiglaukopharmaceutics in last 10 years.

A Research Submitted to the Faculty of Health Sciences (School of Public Health), University of the Witwatersrand, in Partial Fulfilment of the Requirements for the Degree of Masters in Public Health in the field of Social Behaviour Change and Communication 27 May 2014 / Introduction: HIV/AIDS services are now given freely at public health facility level. They have been decentralized to the formal primary health facilities in the rural areas. Despite the efforts by the South African government, the utilization of those services remains a challenge. There are gender disparities in utilisation of HIV/AIDS services as females utilize the services in greater numbers compared to their male counterparts. The newly diagnosed seropositive men tend to disappear soon after HIV testing, only to appear in a formal health system when their immune system is seriously suppressed and at a more advanced WHO stage of disease. Therefore, the overall aim of this study was to explore the underlying perceptions and beliefs that influence utilization of HIV/AIDS services by newly diagnosed HIV positive men in Mbashe Sub-District of the Eastern Cape between January 2010 and March 2011 Methods: The study was conducted in the rural Mbashe Sub-District of the Eastern Cape Province and utilized a qualitative methodology. This qualitative approach relied on semi-structured in-depth interviews with newly diagnosed HIV positive men of 18-49 years of age who were either accessing or not accessing the HIV/AIDS services during January 2010 and March 2011.The participants were recruited through purposive sampling and 18 interviews were conducted in 6 different facilities at three different service levels. Interviews were audio-recorded and transcripts were subjected to thematic content analysis based on the Health Belief Model. Results: The results show that both groups of men reacted negatively to HIV positive status. The experiences during HIV Counselling and Testing were not linked to whether men could access services. The barriers to utilizing the available HIV/AIDS services included fear of stigma and discrimination, need for an alternative quick cure which delayed utilization of the services, the clinic as gendered space, compromised Provider-Initiated Counselling and Testing (PICT) model implementation, shortage of food, physical fitness and alcoholism. The facilitators for access included the need for survival, disclosure and social support, and cues to action like witnessing a relative dying due to HIV/AIDS related illness. However, the HBM model could not squarely explain the trends in accessing HIV service since few constructs were found to be relevant and also some issues that are outside the HBM model emerged. Conclusions: The study demonstrates that newly diagnosed men‟s utilization of the subsequent free HIV/AIDS services at the primary health care level is influenced by many factors . There are those factors that trigger men to utilize the services and those that deter them from accessing necessary HIV/AIDS services. The factors that influence their access to services are mainly within the multilevel framework which ranges from individual, family, community and societal factors. Therefore, the targeted interventions to address the issue should focus on addressing stigma and discrimination, policy change on training, recruitment and deployment of male nurses, integration of traditional/spiritual interventions within the mainstream of health services, correct implementation of the PICT model and encouraging couple counselling and testing. The Health Belief Model constructs, especially perceived severity, were not strongly linked to whether men accessed services or not.

Legislative compliance assessment tools are commonly used by companies to help them to understand their legal obligations. One of the primary limitations of existing tools is that they tend to consider each regulation in isolation. In this paper, we propose a flexible and modular compliance assessment framework that can support multiple legislations. Additionally, we describe our extension of the Open Digital Rights Language (ODRL) so that it can be used not only to represent digital rights but also legislative obligations, and discuss how the proposed model is used to develop a flexible compliance system, where changes to the obligations are automatically reflected in the compliance assessment tool. Finally, we demonstrate the effectiveness of the proposed approach through the development of a General Data Protection Regulatory model and compliance assessment tool

Compliant Actuators are much safer than traditional stiff joint actuators, but at the cost of high overshoot, positional accuracy, and speed. A damper that varies its damping torque during motion is introduced to alleviate these downsides. The equations of motion for the system are derived and simulated. The simulations demonstrated a decrease in the overshoot and ringing time. A physical proof of concept was manufactured and tested. The results from the physical model were inconclusive due to a fault in the physical model. A more accurate physical test model is proposed, and is simulated.

Aboriginal Australians have some of the world�s highest rates of rheumatic fever. Two approaches to reducing the burden of rheumatic fever are discussed in this thesis. The B cell antigen D8/17 has a strong association with rheumatic heart disease and may be a universal marker of inherited susceptibility to rheumatic fever. Identifying a population at increased risk of rheumatic fever provides an opportunity to focus primary prevention measures. In part one of the thesis I evaluate the accuracy of D8/17 as a marker of past rheumatic fever amongst Australians from the Northern Territory. D8/17 levels were measured and compared in patients with acute rheumatic fever, rheumatic heart disease or past rheumatic fever, first-degree relatives and healthy, unrelated controls. The mean percentage of B cells positive for D8/17 was 83.7%, 38.9%, 20.2% and 11.6% respectively. The difference between the groups was significant (p-value less than 0.0001). A receiver operator curve analysis indicated that 22.1% of B cells positive for D8/17 was the most accurate cut-off to distinguish patients with acute or past rheumatic fever from healthy subjects. These results indicated that the B cell antigen D8/17 is an accurate marker of past rheumatic fever in Aboriginal Australians and could be a helpful addition to the Jones Criteria for strengthening or excluding a diagnosis of acute rheumatic fever. The intermediate levels of D8/17 expression in the relatives of index cases supports the hypothesis that D8/17 is a marker of an inherited susceptibility to rheumatic fever, although prospective trials are required to provide conclusive proof of this hypothesis. Non-compliance with secondary prophylaxis was suspected to be the cause of increasing rates of rheumatic fever in the Top End. In part two of the thesis I discuss the �problem of compliance� with respect to Aboriginal patients, and investigate the factors that affected the delivery and uptake of prophylaxis for rheumatic fever in an Aboriginal community. Patients, relatives and health practitioners were interviewed on the topic of the care of patients with rheumatic heart disease. The data were analysed using the principles of grounded theory. The main finding was the desire for more personalised care and support for patients with rheumatic heart disease from the community clinic, rather than simple medical care. These ideas crystallised through two Yolngu terms to describe care: djaka (to physically care for) and gungayun (to encourage). Thus even from the outset there was divergence in the focus of the �consumer�- holistic care - and that of the health-care professional/ researcher � improving the rate of secondary prophylaxis coverage. With regards to service provision, a significant reason for failure to receive secondary prophylaxis was the differing approaches of urban and community health services, patient mobility, and a differing understanding of the responsibilities of patients and health service providers in the different settings. Other factors pertaining to service provision, such as staff motivation, administrative issues and program coordination affected the uptake of secondary prophylaxis to a lesser extent. With regards to treatment uptake, individual patient factors inhibiting uptake of treatment were apparent in some cases, but treatment refusal was rare. Pain was not found to be a deterrent. No simple relationship was found between treatment compliance and biomedical knowledge of the disease. There was no simple relationship between patient passivity and sense of responsibility that guaranteed compliance. This study demonstrated that the failure to achieve good uptake of prophylaxis for rheumatic fever related as much to factors of service provision as patient factors and that providing holistic care within a familiar and supportive framework is important to Yolngu patients. However, there are real difficulties for health services as they are currently structured to meet the expectations of patients and families.

<p>Begreppen ”compliance, adherence och concordance” används inom många delar av omvårdnadsforskningen. Dessa begrepp används frekvent inom det njurmedicinska forskningsfältet eftersom njurmedicin är ett område med komplexa behandlingar som ställer stora krav på både vårdpersonal och patienter. Syftet med denna litteraturstudie var att beskriva vad dessa begrepp egentligen betyder och hur de används. För att uppnå dessa mål har artiklar sökts i flera databaser och därefter noga lästs igenom och analyserats metodiskt. Resultatet visar att det saknas entydiga definitioner av begreppen. Dessutom råder det en viss begreppsförvirring då man i vissa studier använder begreppen som synonymer trots att de enligt de flesta definitioner inte är det. Sammantaget gör detta att det blir svårvärderat hur man skall använda resultaten i utförda studier med dessa begrepp som mätpunkter och det leder dessutom till svårigheter i jämförelser mellan olika studier. En annan slutsats i denna litteraturstudie är att compliance anses en aning förlegat och att adherence är det man framförallt använder idag medans concordance tycks vara på frammarsch. Sammanfattningsvis kan man säga att det krävs mer forskning på området för att finna konsensus i nomenklaturen så att studier som utförs kan värderas och jämföras mot varandra.</p> / <p>The terms ”compliance, adherence and concordance” are used in several areas of nursing research. These terms are often used in research covering the field of nephrology since renal medicine is an area with complex treatments that demand much from both health care providers and patients. The aim of this literature review was to clarify these terms actual meaning and how they are used. To reach these goals, articles have been sought in several databases, and articles included have thereafter been read thoroughly and methodically analyzed. The results show that there is no unambiguous definition of the terms. Furthermore there are some confusion regarding how to use the terms and in some studies they are even used as synonyms even though this is wrong according to most definitions. Taken together these points makes it hard to evaluate how to use results from studies with these terms as points of measure it also leads to difficulties in comparing studies with each other. Another conclusion in this study is that compliance is considered a bit obsolete and adherence is what is generally used today while concordance is upcoming. More research is warranted to reach agreement on defining these terms to enhance comparability between studies.</p>