Non-compliance for wearing spectacles: Prevalence and determinants in school-going children in South India

Purpose: To study the prevalence and determinants of compliance with spectacle wear among school?age children in South India who were given spectacles free of charge under a school vision screening program. Methods: A cross?sectional, descriptive study was performed. The participants were recruited from the school from Tirunelveli and Tuticorin districts of Tamil Nadu, where a school vision screening camp was conducted between January 2012 and October 2012. The school screening was performed under “Lavelle Pediatric Eye Care Project”. Of the 129,720 children examined of 249 schools, 4253 of children had refractive error and 3333 were prescribed and dispensed spectacles. A total of 683 children were interviewed, who were not wearing glasses on follow?up. Results: About 20% of the participants (683/3333) were not wearing their spectacles at examination. The most common reasons given for non?wear were lost (44.9%) or broken (35.3%) spectacles. There was no gender preference on compliance to spectacles. Conclusion: Compliance with spectacle wear is less even when spectacles are provided free of cost, particularly in children among the age group of 5–15 years. Because factors such as type of school, area (urban or rural), parent’s income, occupation, and their education were not significantly affecting the compliance of spectacle wear, proper encouragement and counseling of the parents and the child become extremely important.

Treatment Considerations and Pharmacist Collaborative Care in Diabetic Ketoacidosis Management

Diabetic ketoacidosis (DKA) is a medical emergency caused by the lack of insulin. Metabolic acidosis, hyperglycemia, and ketoacidosis are its defining features. Insulin deficiency can cause DKA either in the presence or absence of a triggering event causing a chain of pathophysiological changes. Normalizing volume status, hyperglycemia, electrolytes, and ketoacidosis are the objectivesof DKA treatment. While hospital pharmacists are involved in managing DKA, community or ambulatory care pharmacists can help to prevent DKA. Depending on the particular field of practice, a p harmacist’s engagement in DKA may involve a number of factors. Inpatient pharmacists are in a good position to help with the acute care of DKA. Because they can recognize patients who are at risk for DKA due to factors including medication nonadherence or insulin pump failure, pharmacists in the community or ambulatory-care environment play a crucial role in its prevention. When a patient finds it challenging to navigate prescription plan coverage or a lack of coverage, community pharmacists can help them obtain insulin. Regardless of the professional environment, patient education is essential. Every pharmacist has the ability to give DKA patients thorough medication education that emphasizes the value of adhering to their drug schedule, addresses any obstacles that may occur, and teaches patients how to correctly monitor their blood glucose levels. Studies showed that pharmacists’ medication counseling and treatment monitoring could improve adherence to insulin medication. The aim of this review is to provide evidence that pharmacists can contribute to optimizing medication adherence and decrease the incidence of DKA.

Life style patterns and adherence to pharmacotherapy after acute coronary syndrome: one year follow up study from a tertiary care center in Kashmir, India

Background: Acute coronary syndrome is the leading cause of cardiac mortality and morbidity world over. Modification of life style pattern and adherence to pharmacotherapy plays a vital role in primary and secondary prevention of coronary events. This study was aimed at assessing the penetration of life style modifications and adherence to pharmacotherapy after acute coronary event in our population.Methods: Acute coronary syndrome patients enrolled in the study were examined, interviewed and all the demographic and clinical data was recorded at index event and at 3, 6 and 12 month intervals.Results: A total of 260 patients were enrolled in the study and followed for 12 months. Mean age of patients was 55.6±8.27 years. Males 78.6% and females 21.5%. Hypertension was risk factor in 67.7%, diabetes in 26.2%, smoking in 63.8%, BMI ≥25 in 67.3% and family history of coronary artery disease in 8.8% of the cases at index event. Uncontrolled hypertension was observed in 30.11%, 38.63% and 44.88% patients at 3, 6 and 12 months follow up. Uncontrolled diabetes at 3, 6 and 12 months was found in 58.82%, 66.17% and 73.52% patients. 5.42%, 15.06% and 21.08% cases continued to smoke at 3, 6 and 12 months respectively. Drug non-compliance overall was noted in 9.61%, 17.69% and 23.84% cases at 3, 6 and 12 month follow up.Conclusions: This study highlights the under prevalence of modifiable risk factor change in practice and drug non-compliance after an acute coronary event.

Cumplimiento del Protocolo de Lavado de Manos por profesionales de enfermería en un servicio de salud de la ciudad de Encarnación, marzo-julio del 2019 / Compliance with the handwashing protocol by nursing professionals in a health service of the city of Encarnacion, March-July 2019

El cumplimiento del protocolo de lavado de manos evita las infecciones nosocomiales, mientras que el incumplimiento ocasiona consecuencias como el aumento de la morbimortalidad, la estancia hospitalaria, así como gastos adicionales al sistema sanitario y al usuario. Esto se puede prevenir con el lavado de manos que surgió como teoría desde la antigüedad. El trabajo de investigación fue de tipo observacional descriptivo con enfoque cuantitativo y fue realizado en 24 enfermeros de un servicio de salud de la ciudad de Encarnación con el objetivo de evaluar el cumplimiento del protocolo del lavado de manos establecido en el Manual de Prevención y Control de Infecciones asociado a la Atención de la Salud del año 2017 del Ministerio de Salud Pública y Bienestar Social. Los resultados evidenciaron un 54% de incumplimiento en la técnica de lavado de manos, un 44% de incumplimiento parcial y solamente un 2% de cumplimiento. En cuanto a los cinco momentos del lavado de manos, el 85% no cumplió con todos los momentos y un 70% no ha recibido capacitación referente al lavado de manos en los últimos 2 años. Se evidenció un alto porcentaje de incumplimiento del protocolo de lavado de manos, lo que representa un riesgo para la salud que podría subsanarse con la realización de cursos de capacitaciones o retroalimentación a los profesionales de enfermería

Compliance of handwashing protocol avoid nosocomial infections, while non-compliance causes consequences such as increased morbidity and mortality, hospital stay, additional cost to the health system and the patient. This can be prevented with handwashing which emerged as a theory in ancient times. This study was descriptive observational with quantitative approach and was carried out in 24 nurses at a health service in the city of Encarnacion in order to evaluate the compliance of handwashing protocol, established in the Infection Prevention and Control Manual associated to Health Care of 2017 of the Ministry of Health Care and Social Welfare. The results showed 54% of non-compliance in the handwashing technique, 44% of partial non-compliance and just 2% of compliance. In relation to the five moments of handwashing technique, 85% did not follow all the steps and 70% did not receive training regarding to the hand washing technique in the last 2 years. A high percentage of non-compliance with the hand washing technique protocol was evidenced, which represents a health risk, which can be corrected with training or feedback workshops for nursing professionals

Factors Contributing For Noncompliance Of Follow-Up Care Among Post Cardiac Patients

Objective: Compliance in following healthy diet, physical activity schedule, cessation of smoking and alcohol, medication adherence and regular follow up is very essential component in the management of patients with cardiovascular disease to prevent reoccurrence and reduce mortality. Hence the study was conducted with the aim to assess the factors contributing for noncompliance of follow-up care among post cardiac patients. Methods: Cross-sectional research design was employed with 50 samples who matched the inclusion criteria were selected by convenience sampling technique. Demographic variables data were collected by using structured questionnaire followed by assessed the factors contributing for noncompliance using checklist. Results: The findings of the current study revealed that all physical, psychological, economical, social and spiritual factors were highly influenced the noncompliance. Of these, the highest percentage 80% reported lack of accessibility as well financial support and around 70% percentage reported side effects of medication and low health literacy. Conclusion: Health care providers need to be focussed on interventional strategies especially health education in discharge plan to ensure that these patients adhere to follow up including medication adherence, following physical activity plan, dietary modification, lifestyle changes and regular follow up visit to prevent readmission and lead a successful life.

A study of compliance to DOTS among tuberculosis patients attending a district hospital, Uttar Pradesh

Background: Tuberculosis is an old disease and has deep social impact on the society. It is a re-emergent killer disease with rise in MDR and XDR strains. DOTS strategy under RNTCP has had a substantial impact over the past two decades. Treatment compliance is one of the key factors determining success of TB control program. The objective of this study was to find out the compliance rate with DOTS and factors responsible for non-compliance in the district.Methods: A cross-sectional study was carried out using structured questionnaire in a tuberculosis unit of Chandauli district, Uttar Pradesh. 100 tuberculosis patients aged ≥15 years registered for TB treatment were enrolled in the study.Results: Out of the 100 patients interviewed, majority of patients (95%) complied. The main reasons for non-compliance were improvement in symptoms after initial doses leading to discontinuation of therapy, and side effects of drugs. One of the defaulter migrated, so he could not be traced. Among factors influencing compliance to DOTS most important was strong monitoring.Conclusions: Health education and easy accessibility of healthcare services are required to further improve the compliance of TB treatment. Internet tools and social security schemes can play essential role in increasing awareness and strengthening the monitoring program

Treatment non-compliance and government aided health schemes : a boon or a curse

Purpose: In this study we tried to analyze the prevalence of non-adherence to radiation treatment, the factors behind the unplanned breaks and the evaluation of strategies to overcome such breaks. Materials and Methods: Between January 2017 to October 2017, 486 patients were registered for radical radiotherapy of which 91 patients with unplanned treatment break were identified. We analyzed the social, economic, educational, and therapeutic barriers that led to treatment interruptions. Results: 91 patients of 486 patients registered for radical radiotherapy with unplanned treatment break were identified. The age of such patients ranged from 30 to 85 years with a median age of 52.5 years. 61 were males and 30 were females. 39 patients were from urban areas and 52 belonged to rural area. Of these 91 patients 85 patients were receiving cashless treatment based on BPL cards and 6 were cash paying patients. 52 Patients had Head and neck, 23 had gynecological, 7 with breast and 4 patients had esophageal cancers. Majority of patients in our study had treatment breaks during the mid to end phase of a radical radiotherapy schedule with the onset of Grade II or III acute reactions. Conclusion: As majority of patients were supported by government schemes without any binding factor, some compelling factors like blocking the BPL cards to avail other benefits, or to impose some kind of penalties to avoid wastage of government efforts and resources.

Research on strategies for academic clinical research investigators strengthening follow-up management / 中华医学科研管理杂志

Objective According to the study of academic clinical research managed by Peking University Clinical Research Institute,identified problems that existed during the follow up in clinical research.Strategies and methods were proposed after analyzed the related problems,to enhance the quality of follow-up in clinical research.Methods Analysis of common follow-up management problems found in project management and on-site monitoring.Results Strategies and suggestions were proposed,table tools and management software were recommended to investigators for strengthening follow-up management.Conclusions Investigators should follow the scientific validity,research strategy and methodologies during the implementation of clinical research,to make sure compliance to increase the follow-up rates and guarantee the data quality.

Self-Regulation Assessment Based on Compliance and Noncompliance in Children / Valoración de la Autorregulación con base en el Cumplimiento y el Incumplimiento en los Niños / Avaliação da Autorregulação com base no Cumprimento e no Incumprimento em Crianças

Abstract In this paper, I reflect on the information that compliance and noncompliance behaviors provide about self-regulation development in children. I argue that these behaviors show differences in self-regulation, depending on the level of independence of the children, their motivation, and the emotional activation they express when disobeying. I further suggest methodologies to assess each of these factors. Specifically, I propose to differentiate several types of compliance and noncompliance behaviors, record children's behavior and type of parental control simultaneously, and analyze children's behavior in response to legitimate and illegitimate demands. These distinctions are important for a more thorough and accurate approach to studying self-regulation in children.

Resumen En este trabajo llevo a cabo una reflexión acerca de la información que los comportamientos de cumplimiento e incumplimiento nos brindan acerca del desarrollo de la autorregulación en los niños. Sostengo que las diferencias que estos comportamientos revelan en cuanto a la autorregulación dependen del nivel de autonomía de los niños, su motivación y la activación emocional que demuestran cuando desobedecen. Sugiero también algunas metodologías para valorar cada uno de estos factores. Específicamente, propongo diferenciar entre los distintos tipos de cumplimiento e incumplimiento, registrar de manera simultánea el comportamiento de los niños y el tipo de control ejercido por los padres y analizar el comportamiento con el que responden los niños a exigencias legítimas e ilegítimas. Estas distinciones son importantes para un abordaje más completo y preciso del estudio de la autorregulación en los niños.

Resumo Neste trabalho, realizo uma reflexão sobre a informação que os comportamentos de cumprimento e incumprimento nos oferecem acerca do desenvolvimento da autorregulação em crianças. Sustento que as diferenças que esses comportamentos revelam quanto à autorregulação dependem do nível de autonomia das crianças, sua motivação e a ativação emocional que demonstram quando desobedecem. Sugiro também algumas metodologias para avaliar cada um desses fatores. Em específico, proponho diferenciar entre os tipos de cumprimento e incumprimento, registrar de maneira simultânea o comportamento das crianças e o tipo de controle exercido pelos pais, além de analisar o comportamento com o qual respondem as crianças a exigências legítimas e ilegítimas. Essas diferenciações são importantes para uma abordagem mais completa e precisa do estudo da autorregulação em crianças.

Ethics Committee' s Management of Noncompliance/Violation or Protocol Deviation Report in Clinical Research / 中国医学伦理学

With the promulgation of a series of laws and regulations in our country, the requirement for stand-ardized management of clinical research process are gradually clear, and higher requirements on the following-up review management of ethics committee also are put forward. Through concluding and summarizing 128 noncompli-ance/violation or protocol deviation reports accepted by a hospital in recent two years, this paper analyzed four main problems including that the researchers at management level failed to report or report timely; the researchers reported in irregular filling;the same type of violation/deviation program happened repeatedly and the rectification to the review opinions of ethics committee was ineffective, and also put forward the corresponding suggestions, in order to strengthen and perfect the standard management of noncompliance/violation or protocol deviation report.

Self-care Status of the Aged Diabetic Patients with Noncompliance / 農村醫學 地域保健

OBJECTIVE: The purpose of this study was to describe and understand self-care status of the aged diabetic patients with noncompliance after hospital discharge. METHODS: A qualitative research method was used for the study design. The participants were 15 diabetic patients aged 65 or older who had been admitted more than two times for hyperglycemia in the past 1 year in a general hospital in Daegu. Data were collected from November 1 2015 to March 1 2016 through in-depth personal interview. RESULTS: Patients' knowledge level on causes and symptoms of diabetes was low. Most participants rarely and irregularly checked blood sugar at home. They were under a lot of stress from their family. Due to old age and illness they did not have sufficient physical activity and they have had rarely regular meals. They considered the self-care education program unnecessary and there was limitations of accessibility for education. CONCLUSIONS: The aged diabetic patients who had the repeat admission did not perform self-care activities properly and had problems especially in blood glucose check, support from their family, and health education after returning home. More personalized and community-based self-management education programs will be necessary.

Knowledge, attitudes and perceptions regarding lymphatic filariasis: study on systematic noncompliance with mass drug administration

ABSTRACT The aim of this study was to investigate the epidemiological characteristics, antigenic profile, perceptions, attitudes and practices of individuals who have been systematically non-compliant in mass drug administration (MDA) campaigns targeting lymphatic filariasis, in the municipality of Olinda, State of Pernambuco, Northeastern Brazil. A pretested questionnaire was used to obtain information on socioenvironmental demographics, perceptions of lymphatic filariasis and MDA, and reasons for systematic noncompliance with treatment. A rapid immunochromatographic test (ICT) was performed during the survey to screen for filariasis. It was found that the survey subjects knew about filariasis and MDA. Filariasis was identified as a disease (86.2%) and 74.4% associated it with the presence of swelling in the legs. About 80% knew about MDA, and the main source of information was healthcare workers (68.3%). For men the main reasons for systematic noncompliance with MDA were that “the individual had not received the medication” (p=0.03) and for women “the individual either feared experiencing adverse reactions”. According to the ICT, the prevalence of lymphatic filariasis was 2%. The most important causes of systematic noncompliance were not receiving the drug and fear of side-effects. For successful implementation of MDA programs, good planning, educational campaigns promoting the benefits of MDA, adoption of measures to minimize the impact of adverse effects and improvement of drug distribution logistics are needed.

Factors Related to Noncompliance in Screening and Tracking Mild Cognitive Impairment Patients in a Single Community

OBJECTIVE: We assessed the cumulative conversion rates (CCR) from minor cognitive impairment (MCI) to dementia among individuals who failed to participate in annual screening for dementia. Additionally, we analyzed the reasons for failing to receive follow-up screening in order to develop better strategies for improving follow-up screening rates. METHODS: We contacted MCI patients who had not visited the Dongdaemun-gu Center for Dementia for annual screening during the year following their registration. We compared the CCR from MCI to dementia in the following two groups: subjects registered as having MCI in the Dongdaemun-gu Center for Dementia database and subjects who failed to revisit the center, but who participated in a screening test for dementia after being contacted. The latter participants completed a questionnaire asking reasons for not previously visiting for follow-up screening. RESULTS: The final diagnoses of the 188 subjects who revisited the center only after contact were 19.1% normal, 64.9% MCI and 16.0% dementia. The final diagnoses of the 449 subjects in the Dongdaemun-gu Center for Dementia database were 25.6% normal, 46.1% MCI and 28.3% dementia. The CCR of the revisit-after-contact group was much lower than anticipated. The leading cause for noncompliance was “no need for tests” at 28.2%, followed by “other reasons” at 23.9%, and “I forgot the appointment date” at 19.7%. CONCLUSION: Considering the low dementia detection rate of the group who revisited only after contact and the reasons they gave for noncompliance, there appears to be a need for ongoing outreach and education regarding the course and prognosis of MCI.

Efeitos da atenção parental e da fuga sobre o comportamento de desobedecer em crianças com dermatite atópica / The effects of parental atention and escape on noncompliance behavior in children with atopic dermatitis / Efectos de la atención de los padres y del escape sobre la conducta de desobedecer en niños con dermati-tis atópica

A análise funcional é um meio eficaz de identificar contingências mantenedoras de padrões de comportamento infantis considerados problema. No caso de crianças com dermatite atópica (DA), a desobediência para a realização de tratamento médico é uma queixa comum dos pais, sendo frequentemente considerada um comportamento problema. O presente trabalho objetivou avaliar o efeito da atenção parental e da fuga sobre o comportamento de desobedecer em crianças com DA em situações de tratamento médico. O estudo analisou esse comportamento de quatro crianças com dermatite atópica entre três e sete anos de idade e suas mães por meio do delineamento experimental de caso único de multielementos. Os comportamentos dos participantes foram observados em três condições de avaliação: linha de base, atenção e fuga. A análise funcional das interações permitiu mostrar que cada uma das crianças apresentou diferentes comportamentos sob controle das mesmas contingências (atenção/fuga).

The functional analysis is an effective way to identify maintaining contingencies of childhood behavior considered problematic. For children with atopic dermatitis, noncompliance is a common parent’s complaint, often considered a problem behavior. This study aimed to examine the effects of parental attention and escape in noncompliance behavior of children with atopic dermatitis in a medical treatment situation. The study evaluated this behavior in four typically developing 3­ to 7‑year‑old children with atopic dermatitis and their mothers, according to a single case multielement experimental design. Participants’ behaviors were observed in three conditions of evaluation: baseline, attention and escape. The functional analysis of interactions allowed showing that, each child presents different answers under the control of similar contingencies (attention/ escape).

El análisis funcional es estrategia eficaz para la identificación de las contingencias mantenedoras de padrones conductuais infantiles considerados problema. Con los niños con dermatitis atópica, la desobediencia en la situación de tratamiento médico es una queja muy frecuente en los padres y puede ser frecuentemente considerada un comportamiento problema. El presente estudio tiene por objectivo evaluar el efecto de la atención de los padres y el escape de niños en el comportamiento de desobedecer de niños con dermatitis atópica en situaciones de tratamiento médico. El estudio evaluó este comportamiento en cuatro niños con dermatitis atópica entre tres y siete años y sus madres, a través del delineamiento experimental de sujeto único de multielementos. Las conductas de los participantes fueron observados y evaluados en tres condiciones de evaluación: línea de base, atención y escape. El análisis funcional de las interacciones entre los niños y sus madres demostró que cada uno de los niños presentaron conductas distintas en las mismas contingencias (atención/escape).

Indoor air quality due to secondhand smoke: Signals from selected hospitality locations in rural and urban areas of Bangalore and Dharwad districts in Karnataka, India.

BACKGROUND: Tobacco smoke has compounds that are known as human carcinogens. With every breath of secondhand smoke we inhale thousands of chemicals. The Government of India in the interest of public health has enacted the Cigarette and Other Tobacco Products Act (COTPA), 2003, which bans smoking in all the public places including hotels and restaurants. The purpose of this study was to observe and record air pollution in smoke free and smoke observed locations and thereby find out whether the owners/managers of hotels, restaurants, and bars comply with rules of COTPA. OBJECTIVES: The objectives of the study were to measure and compare the level of particulate air pollution from secondhand smoke (PM2.5) in smoking and nonsmoking venues. MATERIALS AND METHODS: The study was conducted from September 2009 to March 2010 in Karnataka, India following a nonrandom sample of 79 locations, which included restaurants, bars, cafes, hotels, and tea stalls in two districts. The concentration of PM2.5 was measured using a TSI SidePak AM510 Personal Aerosol Monitor. RESULTS: In Karnataka out of the 79 hospitality locations, smoking was observed in 58% places and only 28% had displayed the required “No Smoking” signage. Places where indoor smoking was observed had high levels of air pollution with average 135 PM2.5, which were 3.1 times higher than the average 43 PM2.5 in smoke‑free locations and 14 times higher than the World Health Organization (WHO) target air quality guideline for PM2.5. The average PM2.5 levels in different locations ranged from 11 to 417 μg/m3 and was lower in the case of apparently compliant designated smoking area (DSR). CONCLUSIONS: The patrons and the workers in the hospitality sector continue to be exposed to secondhand smoke despite the enactment of COTPA, which bans smoking in public places. This situation demands stringent measures for effective implementation of the Smoke Free Act and negative response to smoking among civil society.

An assessment of treatment compliance among patients on DOTS under revised national tuberculosis control programme in district Rewa, Madhya Pradesh, India.

Background: India is the highest TB burden country in the world. In the year 2006, annual performance of revised national tuberculosis control programme (RNTCP) in India, in terms of cure rate of new smear positive patients was 84%, default rate was 6.4% while in Madhya Pradesh it was 82% and 7.6% respectively. Rewa district have poor performance as compare to national level. Non-adherence with treatment has been recognized as an important factor responsible for low cure rate and high incidence of drug resistant TB. The objective of study was to find out the compliance rate with DOTS and associated factors responsible for non-compliance in the district. Methods: The present observational study was carried out at fifteen selected DMC cum DOTS centers of Rewa district, M.P. Results: Of the 337 patients interviewed, majority of patients 270 (80.11%) complied and 67 (19.88%) did not comply to treatment. The main reasons for non-compliance were false perception of having their disease cured because they felt well with initial treatment 26 (38.81%), side effects of drugs 23 (34.33%), anxiety of loss of wages 9 (13.43%) and Migration of patients 7 (10.44%). Conclusions: Repeated counselling and motivation of noncompliant patients would be helpful to reduce noncompliance to treatment.

Instrumental Variable Methods and Its Applications in Outcome Research of Traditional Chinese Medicine / 世界科学技术-中医药现代化

This paper was aimed to discuss the feasibility and attentions of application of instrumental variable (IV) methods in traditional Chinese medicine (TCM) outcome research. First, the application of IV was introduced, which included the basic principles and hypothesis, statistical model, estimator of IV and weak IV. Then, an example was given to illustrate the evaluation criteria and attentions of IV. The resultsshowed that IV method was proposed as a potential approach to the problems of confounding in statistics. But using IV methods should be based on a series of statistical hypotheses. It was concluded that the IV analysis was a method controlling confounding bias, but generally it was not chosen as the preferred analytical method. The issue of searching for valid and plausible IV seemed to be the biggest obstacle in the outcome of TCM researches.

Comparative evaluation of molar distalization therapy using pendulum and distal screw appliances / 대한치과교정학회지

OBJECTIVE: To compare dentoalveolar and skeletal changes produced by the pendulum appliance (PA) and the distal screw appliance (DS) in Class II patients. METHODS: Forty-three patients (19 men, 24 women) with Class II malocclusion were retrospectively selected for the study. Twenty-four patients (mean age, 12.2 +/- 1.5 years) were treated with the PA, and 19 patients (mean age, 11.3 +/- 1.9 years) were treated with the DS. The mean distalization time was 7 months for the PA group and 9 months for the DS group. Lateral cephalograms were obtained at T1, before treatment, and at T2, the end of distalization. A Mann-Whitney U test was used for statistical comparisons of the two groups between T1 and T2. RESULTS: PA and DS were equally effective in distalizing maxillary molars (4.7 mm and 4.2 mm, respectively) between T1 and T2; however, the maxillary first molars showed less distal tipping in the DS group than in the PA group (3.2degrees vs. 9.0degrees, respectively). Moreover, significant premolar anchorage loss (2.7 mm) and incisor proclination (5.0degrees) were noted in the PA group, whereas premolar distal movement (1.9 mm) and no significant changes at the incisor (0.1degrees) were observed in the DS group. No significant sagittal or vertical skeletal changes were detected between the two groups during the distalization phase. CONCLUSIONS: PA and DS seem to be equally effective in distalizing maxillary molars; however, greater distal molar tipping and premolar anchorage loss can be expected using PA.

A study of non-compliance with pharmacotherapy in psychiatric patients

Background: Non-compliance to treatment, especially medication is an important area of concern in psychiatry as it contributes to relapse and re-hospitalization of the patients. One of the ways to improve drug compliance is to know crucial factors responsible for poor drug compliance so that proper management strategies may be planned to improve patients’ drug compliance Aims: To find out the reasons for drug non-compliance and its association with socio demographic variables and psychiatric diagnosis. Methods: The study was conducted on patients attending psychiatry outpatient department for duration of seven months to evaluate the reasons for treatment non-compliance, using a questionnaire designed for the purpose. Results: In our study, it was observed that 63.75% of subjects were compliant and 36.25% were non-compliant. A significant association was found between non-compliance and age group more than 46 years, female gender, low socio economic class, low education rate. Non-compliance was highest among patients with schizophrenia (45.16%) and the main reason for drug non-compliance identified in the present study was a lack of knowledge about the nature of illness. Conclusion: The result of the study concludes that the major reason for non-compliance was lack of knowledge about the illness reflecting the importance of psycho education. Key message: Lack of knowledge about the nature of illness was the main reason for non-compliance.

Análise funcional de eventos antecedentes ao comportamento de desobediência de crianças / Functional analysis of antecedent events on children's noncompliance behavior / Análisis funcional de los eventos antecedentes de la conducta de desobediencia de niños

A dermatite atópica é uma doença crônica de pele que se manifesta na infância. A desobediência é uma queixa comum entre os pais dessas crianças. Pesquisas apontam que inúmeros eventos antecedentes podem influenciar a desobediência. O presente estudo objetivou avaliar o efeito da manipulação da atenção parental e da dificuldade da tarefa, como eventos antecedentes, no comportamento de desobediência de cinco crianças com dermatite atópica. O delineamento experimental utilizado foi o de multielementos. Os resultados demonstram que a manipulação de tais variáveis alterou as respostas de desobediência para três das cinco crianças. Sugere-se a necessidade de inclusão dessas variáveis na avaliação, prevenção e intervenção de crianças atópicas cujos pais se queixam de desobediência.

The atopic dermatitis is a chronic skin disease which manifests in childhood. Noncompliance is a common parent's complaint of atopic children. Studies have shown that several antecedent variables can influence noncompliance. The present study aimed to examine the effects of parental attention and task difficult, on noncompliance behavior of five preschoolers' children with atopic dermatitis. The experimental design was the multielement. The results showed that the manipulation of these variables changed noncompliance responses in three of the five children. It suggests the need of including these variables to assess, to prevent and to intervene in children with atopic dermatitis described as noncompliance by their parents.

La dermatopatia es una enfermedad crónica de piel que ocurre en la infancia. La desobediencia es una queja común entre los padres de niños con dermatopatias. Estudios indican que numerosos eventos antecedentes pueden influenciar en la desobediencia. El presente estudio objetivó evaluar el efecto de la manipulación de la atención parental y de la dificultad de la tarea, como eventos antecedentes, en la desobediencia de niños con dermatopatias. El diseño experimental utilizado fuera el multielementos. Los resultados indicaron que la manipulación de las variables alteró las respuestas de desobediencia para tres dos cinco niños evaluados. Sugiere incluir estas variables en la evaluación, prevención e intervención de niños con dermatopatias y desobediencia.