Non-compliance in surveillance for patients with previous resection of large (≥ 1 cm) colorectal adenomas

AIM: To assess the extent and reasons of non- compliance in surveillance for patients undergoing polypectomy of large (≥ 1 cm) colorectal adenomas. METHODS: Between 1995 and 2002, colorectal adenomas ≥ 1 cm were diagnosed in 210 patients and subsequently documented at the Erlangen Registry of Colorectal Polyps. One hundred and fi fty-eight patients (75.2%) could be contacted by telephone and agreed to be interviewed. Additionally, records were obtained from the treating physicians. RESULTS: Fifty-four out of 158 patients (34.2%) neglected any surveillance. Reasons for non-compliance included lack of knowledge concerning surveillance intervals (45.8%), no symptoms (29.2%), fear of examination (18.8%) or old age/severe illness (6.3%). In a multivariate analysis, the factors including female gender (P = 0.036) and age > 62 years (P = 0.016) proved to be signif icantly associated with non-compliance in surveillance. CONCLUSION: Efforts to increase compliance in surveillance are of utmost importance. This applies particularly to women’s compliance. Effective strategies for avoiding metachronous colorectal adenoma and cancer should focus on both the improvement in awareness and knowledge of patients and information about physicians for surveillance.

Contribution of Risk Perception for the Analysis of Non-Compliance to Work Procedures

One of the problems encountered in work security is non-compliance to work procedures by operators. The consequences of such human behavior are harmful to both the operators and the organization. These consequences are the result of a situational behavior of operators. This article focuses on the perception of work situations in a sample of Algerian workers in oil companies knowing that this perception determines, in large part, the decisions taken by the operators in terms of non-compliance with work procedures.

Understanding the deterrence effect of punishment for marine information security policies non-compliance

In the organizational setting of marine engineering,a significant number of information security incidents have been arised from the employees’failure to comply with the information security policies(ISPs).This may be treated as a principal-agent problem with moral hazard between the employer and the employee for the practical compliance effort of an employee is not observable without high cost-.On the other hand,according to the deterrence theory,the employer and the employee are inherently self-interested beings.It is worth examining to what extent the employee is self-interested in the marine ISPs compliance context.Moreover,it is important to clarify the proper degree of severity of punishment in terms of the deterrent effect.In this study,a marine ISPs compliance game model has been proposed to evaluate the deterrence effect of punishment on the non-compliance behavior of employee individuals.It is found that in a non-punishment contract,the employee will decline to comply with the marine ISPs;but in a punishment contract,appropriate punishment will lead her to select the marine ISPs compliance effort level expected by the employer,and cause no potential backfire effect.

Adherence to medication: A nation-wide study from the Children's Cancer Hospital, Egypt

AIM: To investigate adherence to medical regimen and predictors for non-adherence among children with cancer in Egypt. METHODS: We administered two study specific questionnaires to 304 parents of children diagnosed with cancer at the Children's Cancer Hospital in Cairo, Egypt, one before the first chemotherapy treatment and the other before the third. The questionnaires were translated to colloquial Egyptian Arabic, and due, to the high illiteracy level in Egypt an interviewer read thequestions in Arabic to each parent and registered the answers. Both questionnaires consisted of almost 90 questions each. In addition, a Case Report Form was filled in from the child's medical journal. The study period consisted of 7 mo(February until September 2008) and we had a participation rate of 97%. Descriptive statistics are presented and Fisher's exact test was used to check for possible differences between the adherent and non-adherent groups. A P-value below 0.05 was considered significant. Software used was SAS version 9.3 for Windows(SAS Institute Inc., Cary, NC, United States).RESULTS: Two hundred and eighty-one(90%) parents answered the second questionnaire, regarding their child's adherence behaviour. Approximately two thirds of the children admitted to their third chemotherapy treatment had received medical recommendations upon discharge from the first or second chemotherapy treatment(181/281, 64%). Sixty-eight percent(123/181) of the parents who were given medical recommendations reported that their child did not follow the recommendations. Two main predictors were found for non-adherence: child resistance(111/123, 90%) and inadequate information(100/123, 81%). In the adherent group, 20% of the parents(n = 12/58) reported trust in their child's doctor while 14 percent 8/58 reported trust in the other health-care professionals. Corresponding numbers for the non-adherent group are 8/123(7%) for both their child's doctor and other health-care professionals. Almost all of the parents expressed a lack of optimism towards the treatment(116/121, 96%), yet they reported an intention to continue with the treatment for two main reasons, for the sake of their child's life(70%)(P = 0.005) and worry that their child would die if they discontinued the treatment(81%)(P < 0.0001).CONCLUSION: Non-adherence to medical regimen is common among children diagnosed with cancer inEgypt, the main reasons being child resistance and inadequate information.

A study on utilization of anti-asthmatic drugs at a medical college hospital in India

Objective:To study the usage of anti-asthmatic dugs and enumerate the patients’ noncompliance. Methods:The study was conducted from 5th Feb,2006 to 5th Mar,2006.The samples were from the general medicine ward.All patients with respiratory tract infection who received anti-asthmatic drugs were included in the study.Data were collected from clinical notes and structured patient’s data,and patient interview utilizing a piloted questionnaire data collection form.The questionnaire included patient demographics,anti-asthmatics prescribed, dose,frequency and previous treatment if any and its duration,concomitant medications etc. Results:26.31%of patients were 61-70 years old.Among 57 patients,91.23%of patients received multi-therapy,8.77%of patients received mono-therapy,59.65%of patients took over the counter(OTC) drugs and 57.89%of patients were non compliant.Anti-asthmatic drugs were prescribed to asthmatic patients as oral,inhalation and others(injections),and more than one route were used for administration of drugs.Conclusion:The anti-asthmatics are used to treat breathing difficulties such as allergy.Poor compliance to treatment is common among the patients,which makes it difficult to manage asthma and increases both morbidity and mortality.It is suggested that interventions have to be done by providing counseling and improving the current prescribing trend for better and rational utilization.

Potential factors influencing lymphatic filariasis transmission in"hotspot"and"control"areas in Ghana:the importance of vectors

Background:Mass drug administration(MDA)programmes for the control of lymphatic filariasis in Ghana,have been ongoing in some endemic districts for 16 years.The current study aimed to assess factors that govern the success of MDA programmes for breaking transmission of lymphatic filariasis in Ghana.Methods:The study was undertaken in two"hotspot"districts(Ahanta West and Kassena Nankana West)and two control districts(Mpohor and Bongo)in Ghana.Mosquitoes were collected and identified using morphological and molecular tools.A proportion of the cibarial armatures of each species was examined.Dissections were performed onAnopheles gambiae for filarial worm detection.A questionnaire was administered to obtain information on MDA compliance and vector control activities.Data were compared between districts to determine factors that might explain persistent transmission of lymphatic filariasis.Results:High numbers of mosquitoes were sampled in Ahanta West district compared to Mpohor district(F=16.09,P=0.002).There was no significant difference between the numbers of mosquitoes collected in Kassena Nankana West and Bongo districts(F=2.16,P=0.185).Mansonia species were predominant in Ahanta West district.An.coluzzii mosquitoes were prevalent in all districts.An.melas with infected and infective filarial worms was found only in Ahanta West district.No differences were found in cibarial teeth numbers and shape for mosquito species in the surveyed districts.Reported MDA coverage was high in all districts.The average use of bednet and indoor residual spraying was 82.4 and 66.2%,respectively.There was high compliance in the five preceding MDA rounds in Ahanta West and Kassena Nankana West districts,both considered hotspots of lymphatic filariasis transmission.Conclusions:The study on persistent transmission of lymphatic filariasis in the two areas in Ghana present information that shows the importance of local understanding of factors affecting control and elimination of lymphatic filariasis.Unlike Kassena Nankana West district where transmission dynamics could be explained by initial infection prevalence and low vector densities,ongoing lymphatic filariasis transmission in Ahanta West district might be explained by high biting rates ofAn.gambiae and initial infection prevalence,coupled with high densities ofAn.melas andMansonia vector species that have low or no teeth and exhibiting limitation.

Bee honey and exercise for improving physical performance,reducing fatigue,and promoting an active lifestyle during COVID-19

An active lifestyle has enormous health benefits.However,physical activity has globally decreased since the beginning of the current coronavirus disease 2019(COVID-19)outbreak because of social distancing measures.Older adults and people with age-related diseases(e.g.,diabetes,obesity,cancer,cardiovascular disorders,etc.)are widely affected by COVID-19 and its grave adverse effects because of their baseline poor immune function.Although they are in intense need for the therapeutic benefits of exercise,they may express a low capacity for exercising due to skeletal muscle dysfunction and low motivation.Honey is a natural energy-rich,low glycemic index food with a variety of biological activities.It is reported to correct muscle pathology in diseased conditions.Because skeletal muscle is the key structure involved in the exercise,we explored the literature for the exercise-promoting potential of natural honey.Bee honey improves physical performance at moderate levels of activity,and it reduces the production of inflammatory cytokines and biomarkers of fatigue following strenuous exercise among athletes.Supplementing ischemic heart disease patients with honey combined with floral pollen improved patients’tolerance for physical loads and corrected metabolic dysfunctions.Therefore,the therapeutic use of honey may have implications for increasing the capacity for exercise in aged and diseased individuals.Soundly designed studies are needed to evaluate such possibilities.