Browsing by Subject "Compliance"

Now showing 1 - 6 of 6
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    Assessing Validity of Self-Reported Dietary Intake within a Mediterranean Diet Cluster Randomized Controlled Trial among US Firefighters
    (MDPI, 2019-09-19) Sotos-Prieto, Mercedes; Christophi, Costas; Black, Alicen; Furtado, Jeremy D.; Song, Yiqing; Magiatis, Prokopios; Papakonstantinou, Aikaterini; Melliou, Eleni; Moffatt, Steven; Kales, Stefanos N.; Epidemiology, School of Public Health
    Collecting dietary intake data is associated with challenges due to the subjective nature of self-administered instruments. Biomarkers may objectively estimate the consumption of specific dietary items or help assess compliance in dietary intervention studies. Our aim was to use a panel of plasma and urine biomarkers to assess the validity of self-reported dietary intake using a modified Mediterranean Diet Scale (mMDS) among firefighters participating in Feeding America's Bravest (FAB), an MD cluster-randomized controlled trial. In our nested biomarker pilot study, participants were randomly selected from both the MD intervention group (n = 24) and the control group (n = 24) after 12-months of dietary intervention. At baseline data collection for the pilot study (t = 12-months of FAB), participants in the control group crossed-over to receive the MD intervention (active intervention) for 6-months. Participants in the intervention group continued in a self-sustained continuation phase (SSP) of the intervention. Food frequency questionnaires (FFQ), 13-item-mMDS questionnaires, 40 plasma fatty acids, inflammatory biomarkers and urinary hydroxytyrosol and tyrosol were analyzed at both time points. Spearman's correlation, t-tests and linear regression coefficients were calculated using SAS software. Overall, the mMDS derived from the FFQ was highly correlated with the specific 13-domain-mMDS (r = 0.74). The concordance between the two questionnaires for low and high adherence to MD was high for all the participants in the parent trial (κ = 0.76). After 6 months of intervention in the pilot study, plasma saturated fatty acid decreased in both groups (active intervention: -1.3 ± 1.7; p = 0.002; SSP: -1.12 ± 1.90; p = 0.014) and oleic acid improved in the SSP (p = 0.013). Intake of olive oil was positively associated with plasma omega-3 (p = 0.004) and negatively with TNF-α (p < 0.001) at baseline. Choosing olive oil as a type of fat was also associated with higher levels of plasma omega-3 (p = 0.019) at baseline and lower TNF-α (p = 0.023) at follow up. Intake of red and processed meats were associated with lower serum omega-3 (p = 0.04) and fish consumption was associated with lower IL-6 at baseline (p = 0.022). The overall mMDS was associated with an increase in plasma omega-3 (p = 0.021). Good correlation was found between nutrient intake from the FFQ and the corresponding plasma biomarkers (omega-3, EPA and DHA). In this MD randomized controlled trial, some key plasma biomarkers were significantly associated with key MD diet components and the overall mMDS supporting the validity of the mMDS questionnaire as well as compliance with the intervention.
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    Association of Socioeconomic Status With Relapse After Ponseti Method Treatment of Idiopathic Clubfeet
    (Sage, 2022-08-26) Akinyoola, Lawrence A.; Gunderson, Zachary; Sun, Seungyup; Fitzgerald, Ryan; Caltoum, Christine B.; Christman, Tyler W.; Bielski, Robert; Loder, Randall T.; Medicine, School of Medicine
    Background: The Ponseti method is today's standard treatment of idiopathic talipes equinovarus (ITEV). Compliance with foot abduction bracing (FABO) and socioeconomic factors have been shown to impact treatment outcome. We wished to further study socioeconomic factors using the Area Deprivation Index (ADI), a more comprehensive way to evaluate socioeconomic status, which has not been done before. Methods: All TEV patients from 2010 through 2019 treated with the Ponseti method were reviewed. Standard demographic variables, as well as the number of casts to complete initial correction, FABO compliance, and occurrence of relapse were tabulated. Socioeconomic level was quantified with the 2018 ADI. Results: There were 168 children; 151 had typical and 17 complex TEV. Average follow-up was 4.3 ± 1.8 years; relapse occurred in 46%. There were no significant differences in the percentage of relapse by sex, race, or ADI. FABO noncompliance was present in 46%. Relapse increased with increasing time of follow-up and FABO noncompliance (76% vs 21%, P < 10-6). Multivariate logistic regression analysis revealed that only FABO compliance and length of follow-up were associated with relapse. The OR of relapse for FABO noncompliance was 17.9 (7.6, 42.4, P < 10-6) and for follow-up >4 years the OR was 4.97 (2.1, 11.70, P = .0003). Conclusion: The outcome of the Ponseti method for TEV treatment is dependent on local circumstances. In our state, socioeconomic status, as determined by the ADI, was not associated with the occurrence of relapse. Thus, each center needs to assess its results, and analyze its own reasons for relapse. There were no other demographic variables associated with relapse except FABO compliance and length of follow-up. Parents should be strongly advised that FABO compliance and follow-up appears paramount to achieving the best results, and that complex TEV are at greater risk for relapse.
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    Biomembrane-mimicking lipid bilayer system as a mechanically tunable cell substrate
    (Elsevier B.V., 2014-03) Lautscham, Lena A.; Lin, Corey Y.; Auernheimer, Vera; Naumann, Christoph A.; Goldmann, Wolfgang H.; Fabry, Ben; Department of Chemistry & Chemical Biology, School of Science
    Cell behavior such as cell adhesion, spreading, and contraction critically depends on the elastic properties of the extracellular matrix. It is not known, however, how cells respond to viscoelastic or plastic material properties that more closely resemble the mechanical environment that cells encounter in the body. In this report, we employ viscoelastic and plastic biomembrane-mimicking cell substrates. The compliance of the substrates can be tuned by increasing the number of polymer-tethered bilayers. This leaves the density and conformation of adhesive ligands on the top bilayer unaltered. We then observe the response of fibroblasts to these property changes. For comparison, we also study the cells on soft polyacrylamide and hard glass surfaces. Cell morphology, motility, cell stiffness, contractile forces and adhesive contact size all decrease on more compliant matrices but are less sensitive to changes in matrix dissipative properties. These data suggest that cells are able to feel and respond predominantly to the effective matrix compliance, which arises as a combination of substrate and adhesive ligand mechanical properties.
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    A Quasi-Experimental Evaluation of High Emitter Non-Compliance and its Impact on Vehicular Tailpipe Emissions in Atlanta, 1997-2001
    (2006-01) Zia, Asim; Norton, Bryan G.; Noonan, Douglas S.; Rodgers, Michael O.; DeHart-Davis, Leisha
    A quasi-experimental evaluation is employed to assess the compliance behavior of high emitters in response to Atlanta’s Inspection and Maintenance program between 1997 and 2001 and to predict the impact of compliance behavior on vehicular tailpipe emissions of ozone precursors, such as carbon monoxide, hydrocarbons and nitrogen oxide. Remote sensing data of a sample of approximately 0.8 million observations of on-road vehicles are matched with IM program data and vehicle registration data to identify the compliant and non-compliant high emitters. A mixed-pool time-series regression analysis is carried out to predict changes in the vehicular tailpipe emissions due to the compliance and non-compliance of the high emitters in the Atlanta airshed.
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    Suppliers’ non-compliance with sustainability standards: a new perspective based on discrete-choice experiments
    (2017) Zamur, Guilherme A. C.; Paiva, Ely Laureano; Flynn, Barbara B.
    What are the factors that contribute to non-compliance with a supply chain partner’s sustainability efforts? Based on institutional theory and social cognitive theory, a discrete-choice experiment was conducted with 128 U.S., 105 Brazilian and 109 Indian managers to test alternative causes of suppliers’ non-compliance. Results of regression modeling provide preliminary evidence to support the idea that managers’ cultural and institutional background influence the way they perceive compliance with the buyer firm’s sustainability practices and that certain positions in the supply chain influence their likelihood to not comply with them.
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    Treatment of breast cancer: Imo State Nigeria versus Indiana, USA women -- comparative analytic study
    (West African College of Surgeons, 2014-10) Anele, A.A.; Bowling, M.; Eckert, G.J.; Gonzalez, Edward L. F.; Kipher, H.; Sauder, C.; Department of Surgery, IU School of Medicine
    BACKGROUND: Women with breast cancer undergo multimodal treatment for best outcome. This study seeks to identify the treatment challenges for such women in Imo State, Nigeria vis-à-vis similar women in Indiana USA. We compared the treatment modalities of both groups; noting predictors of compliance for subsequent action. SETTING: Federal Medical Centre, Owerri; Imo State, Imo State University, Orlu, Nigeria and Indiana University Hospital, Indiana, USA. DESIGN: A retrospective study. METHODOLOGY: From 2000-2013, 100 randomly pulled charts of patients treated for pathologically confirmed breast cancer in Imo, Nigeria Federal Medical Centre Owerri, Imo State University Hospital; and Indiana University Hospital U.S. respectively were reviewed. The demographics, clinical and pathological data of the patients with confirmed breast cancer were obtained. The data were formatted and analyzed with SPSS version 16.0. The clinical features, management options, outcomes and specific features were compared for both groups using Wilcoxon Rank Sum tests (age, parity) and chi-square tests for all other variables. A 5% significance level was used for all tests. RESULTS: One hundred patients were included for each group. The mean/minimum ages; Imo, Nigeria 41.7/21 (SD/SE 15.3/1.5) vs. Indiana, U.S.56.4/29 (SD 12.4/SE 1.2) p<0.0001. Histology for Indiana USA women was predominantly ductal carcinoma in situ (DCIS) P<0.0001 while that of Imo, Nigeria was invasive ductal carcinoma inflammatory cancer P<0.0326. Women in both locations received chemotherapy and surgery. Imo women received less radiotherapy. Toxicity from chemotherapy remained constant features for both groups, P<0.0001. In Indiana USA, the 5year survival exceeded 85%; In Imo Nigeria it was 10%. This study showed that Women on both locations who were likely to be compliant were those receiving mastectomy; Imo, Nigeria 44(56%) <0.013 vs. Indiana, U.S. 74(80%) p<0.0186; women with cosmesis given; Imo, Nigeria 41(42%) vs. Indiana, U.S. 91 (94%) p<0.0001. Sample sizes were inadequate to perform multivariable models. CONCLUSION: The multimodal treatment regimen implied that there was need for an algorithm protocol for breast cancer women. Thus the need to improve the quality of treatment particularly in Nigeria by improved treatment documentation to overcome key barriers involving information exchange.