Compliance Drawbacks

Solutions The reasons behind choosing solutions over other dosage forms are their favorable cost advantage, the simplicity of formulation development and production, and the high acceptance by patients [170], However, there are also a few drawbacks, such as rapid and extensive precorneal loss, high absorption via the conjunctiva and the nasolacrimal duct leading to systemic side effects, as well as the increased installation frequency resulting in low patient compliance. 

One of the drawbacks of biological agents is the need for parenteral routes of administration. In some cases, these agents are administered as subcutaneous injections, which reduces the number of clinic visits required for treatment. However, many of these agents require frequent dosing because of their short half-life. The discomfort associated with frequent injections can negatively impact patient compliance and there are other issues associated with the disposal of used syringes. 

Infection of bone, known as osteomyelitis, remains one of the most serious clinical complications associated with open reduction and internal fracture fixation. Gonventional intravenous therapy with systemic antibiotics is the major modality of treatment employed by clinicians, but such therapy has inherent drawbacks. Long-term intravenous therapy often requires the use of indwelling intravenous lines which have the potential for serious morbidity including line infections and deep venous thromboses. In addition, dosing of the antibiotics may be as often as several times per day, which can lead to a decrease in patient compliance as well as increased risk of infection. Additionally, many systemic antibiotics have relatively narrow therapeutic windows, and their potential for toxicity requires close clinical monitoring. But even when drug toxicity and line-related complications are avoided, treatment of such infections has a less-than-impressive success record. - ... 

In response to these concerns, and particularly the ones associated with tire nonabsorbable cyanoacrylates that are used clinically. Linden and Shalaby disclosed a novel, absorbable tissue adhesive composition that addressed, to a practical extent, the drawbacks of the absorbable bioadhesive as well as nonabsorbable cyanoacrylates. In effect, these absorbable tissue adhesive compositions were based (1) primarily on methoxyalkyl cyanoacrylates and preferably methoxypropyl cyanoacrylate as the precursor of an absorbable tissue adhesive polymer and (2) on a polymeric, highly absorbable, liquid comprising an oxalate ester of triethylene glycol as a modifier to modulate the viscosity of the overall composition, lower the heat of polymerization, and increase the compliance and absorption rate of the cured adhesive joint. In a more recent disclosure by Shalaby, a number of other useful modifiers were described and the functional performance of the new adhesive compositions was reported. ... 

Closed-bore MRI manipulation requires actuators with excellent MRI compatibility because of their proximity to the image center. Piezoelectric motors have been reported to cause image distortion in closed-bore MRI [19]. Piezoelectric motors are also relatively slow, complex and expensive. Manipulators using pneumatics have had limited success in conjunction with closed-bore MRI [20, 21]. The main drawbacks to this approach are control issues due to the imprecision and compliance of pneumatics. Recent advances have been made using pneumatic stepper motors to eliminate these effects [22]. However, pneumatic systems, using continuous cylinders or step motors, tend to be complex and expensive. 

Workers do not always follow procedures (Dekker, 2003). One of the most prominent problems associated with the use of procedures is operator noncompliance. Violations of procedures are a significant cause of industrial accidents and are a frequent cause of production losses, poor quality, and unreliable maintenance (HSE, 1995). According to Dekker (2003), there is a history of industrial disasters where a lack of procedural compliance played a role. Procedural noncompliance can take the form of unintentional noncompliance, where the operator unknowingly deviates from a procedure due to factors such as memory lapses or misinterpretation, or intentional noncompliance, where the operator knowingly ignores a procedure, often due to a perception that following the procedure offers more drawbacks than benefits (Ockerman and Pritchett, 2001). 

Despite its simplicity, the use of adsorption media has major drawbacks in particular for application in remote rural areas which is of high importance for worldwide groundwater treatment (i) supply of adsorption media needs to be ensured, (ii) safe disposal of exhausted media or regeneration, (iii) adsorption capacity largely depends on the particular feed water quality such as e.g. presence co-ions, pH, hence in many cases safe compliance with MCL cannot be ensured. 

Some regulators have developed their in-house solution for software based assessment of the ACP security level [personal communication]. These tools simulate operational aspects like throughput but also security aspects, e.g. detection rate and compliance with current regulations. Usually these tools have a Monte Carlo approach in common, using several instances of a passenger type with distributions for carried threats and other relevant attributes. TSA developed a Security Checkpoint Optimizer (SCO) software to simulate operational and security performance (Wilson et al., 2007). All these tools have the drawback that the components are thought as statistically independent and no human factors with regard to the ACP staff are taken into account, obviously a major model restriction. 

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