Know-Your-Customer (KYC) Requirements for Initial Coin Offerings

Blockchain technology is often proposed as an infrastructure for decentralized Know-Your-Customer (KYC) verification, i.e., a process determining whether a customer is eligible for a given transaction. The benefit of using blockchain technology lies in the expected compliance costs reduction for companies by automatically enforcing KYC-requirements, whose results are accessible by multiple financial institutions. While information systems researchers have proposed conceptual models and prototypes of blockchain-based KYC-systems, they do not yet consider severe penalties that are applicable to companies if KYC-requirements are not met. Hence, if the legal requirements for KYC-processes cannot be met, these systems are not applicable. The paper uses an objective-centered design science research approach to develop a blockchain-based KYC-system for the conduct of ICOs that is compliant-by-design. To this end, the authors first identify existing KYC-requirements and define corresponding system design objectives that are used to develop a KYC-system that automatically enforces KYC-regulations, thereby preventing money laundering and other forms of identity fraud. Second, the authors contribute to the literature by providing a blueprint for compliant-by-design blockchain-based KYC-systems, in the paper, integrated into the investment flow of an ICO. Third, the authors propose a KYC-system that is applicable in the real world, by making – due to legal certainty – KYC-processes cost-effective, i.e., the proposed blockchain-based KYC-system expectably reduces compliance costs for customers and financial organizations.

Social uncertainties related to stable iodine intake in a nuclear emergency

Intake of stable iodine intake is considered as an effective countermeasure for reducing the risk of thyroid cancer in an eventual release of radioactive iodine following nuclear accident. However, there are a number of value and social uncertainties that are likely to impact on accident management. These include differences in public response as well as decisions made by emergency management actors during an actual incident. In order to explore these sources of uncertainty, this paper explored social uncertainties related to the potential administration of stable iodine. First, public understanding and compliance with the advice of authorities was studied by surveys, showing that less than half of the public knew when iodine tablets should be taken, or understood their protective role. There were also country specific differences in the level of expected compliance with authorities’ advice. Second, social uncertainties were identified through observations of emergency exercises; these were revealed to be mainly related to timing, public response, communication, effectiveness, cross-border issues and first responders. Third, studies on factors influencing communication about stable iodine were carried out and showed that public understanding and compliance with advice could be improved by communicating numerical and narrative information. Overall, the results indicate that enhanced focus on social uncertainties during the preparedness phase may improve the effectiveness of stable iodine administration in case of an emergency.

Legitimacy of authoritarian law: Legal compliance in China

Very few studies of legal compliance have been conducted outside the context of liberal democracies. This study tests and expands theoretical expectations regarding legitimacy and its effect on legal compliance in the context of China, a society under authoritarian rule where clashing cultural discourses coexist. In addition, it examines different types of laws, highlighting the importance of social relations regulated by and cultural elements supporting various laws. Using linear regressions with data from an original representative social survey of 556 individuals in Chengdu, China, the author finds that (1) the perceived legitimacy of law, (2) expectations concerning compliance with law, and, most importantly, (3) the association between law’s legitimacy and expected compliance all vary according to the type of social relationship targeted by the legal regulation (familial, state-oriented, or economic). The article shows how China’s cultural, political, and historical environments contribute to the patterns identified in this analysis.

Food safety in food services in Lombardy: proposal for an inspection-scoring model

The purpose of this study was to elaborate a checklist with an inspection scoring system at national level in order to assess compliance with sanitary hygiene requirements of food services. The inspection scoring system was elaborated taking into account the guidelines drawn up by NYC Department of Food Safety and Mental Hygiene. Moreover the checklist was used simultaneously with the standard inspection protocol adopted by Servizio Igiene Alimenti Nutrizione (Servizio Igiene Alimenti Nutrizione - Ss. I.A.N) and defined by D.G.R 6 March 2017 – n. X/6299 Lombardy Region. Ss. I.A.N protocol consists of a qualitative response according to which we have generated a new protocol with three different grading: A, B and C. The designed checklist was divided into 17 sections. Each section corresponds to prerequisites to be verified during the inspection. Every section includes the type of conformity to check and the type of violation: critical or general. Moreover, the failure to respect the expected compliance generates 4 severity levels that correspond to score classes. A total of 7 food services were checked with the two different inspection methods. The checklist results generated a food safety score for each food service that ranged from 0.0 (no flaws observed) to 187.2, and generates three grading class: A (0.0-28.0); B (29.0 - 70.0) and C (>71.00). The results from the Ss. I. A. N grading method and the checklist show positive correlation (r=0.94, P>0.01) suggesting that the methods are comparable. Moreover, our scoring checklist is an easy and unique method compared to standard and allows also managers to perform effective surveillance programs in food service.

Physician Factors Determining Treatment Decisions in Selecting Second Line Agents for Pediatric ITP

Background: Decision-making in selecting second-line therapies for pediatric patients with immune thrombocytopenia (ITP) has not been studied. Using data collected from physicians experienced in treating ITP, we developed a conceptual model of factors that informed treatment choice. This study was a component of ICON1, a prospective, observational, longitudinal cohort study of second line treatments for childhood ITP performed by the Pediatric ITP Consortium of North America (ICON). Methods: Physicians who enrolled patients in ICON1 were asked to rank the top three reasons they chose a specific treatment so as to weight each factor. Those choices that were ranked 1, 2, or 3 were weighted to develop a propensity scored decisional model. In other questions, physicians were asked about all factors that may have influenced decisions to begin a particular second line therapy and this data was then used to examine additional factors that influenced therapy choices and to compare between therapies. Results: ICON1 enrolled 118 patients; 101 had primary ITP and 53 were receiving their first second line therapy. The majority of physicians in the study saw eleven or more patients per year, and the time since completion of fellowship ranged from 1 to 44 years (mean 12.5 (SD 11)). The most important factors guiding treatment decisions in propensity weighted modeling were "patient preference factors": patient/parental preference (40%), and treatment-related factors: possibility of remission (38%), side effect profile (36%), efficacy (27%), long-term toxicity (33%), and ease of administration (30%). Physician factors, such as experience and adhering to published guidelines, rarely influenced decision-making with only 2% of physicians giving published guidelines as a reason for choice of therapy, and there being no difference in choice based on years since fellowship or experience in treating ITP patients. However, 28% of physicians stated their comfort level with a treatment strongly influenced their choice. Additionally, 38% of physicians did not endorse any patient clinical factors (e.g. frequency of bleeding, expected compliance, response to other therapies, age, comorbidities) as key in their decision-making. Health system factors, such as insurance approval or distance from the closest medical center, rarely influenced treatment choice. Treatments could be categorized into five groups: oral immunosuppressive agents, rituximab, romiplostim, eltrombopag or splenectomy. A significant determinant of choosing splenectomy or rituximab was the "possibility of long-term remission" (p<0.001). A high percentage of treatment factors impacted the decision to prescribe: for rituximab 92% of physicians endorsed at least one treatment factor; for oral immunosuppressants, and romiplostim and eltrombopag, 100% of physicians endorsed at least one treatment factor. Among the top 3 choices for each medication, treatment related factors were major determinants (Table). Oral agents, were significantly more likely to be chosen for ease of administration and expected adherence (p<0.001). When examining the reasons physicians chose particular therapies, physicians indicated "this agent is most efficacious" most frequently for romiplostim, but not for eltrombopag (p<0.001) and were more likely to choose rituximab in patients in whom there was lower expected compliance (p=0.017). Conclusions: This first analysis of physician decision making regarding second line therapies shows that patient preference and physician perception of treatment characteristics (efficacy, side effects, possibility of long term remission) are primary drivers of physician choice in contrast to guidelines, clinical characteristics and health system factors. Future comparative effectiveness studies are necessary to better inform patient and physician choice. Disclosures Lambert: Novartis: Consultancy. Grace:Agios Pharmaceuticals: Other: Scientific Advisor, Research Funding. Bussel:Cangene: Research Funding; GSK: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Ligand: Membership on an entity's Board of Directors or advisory committees, Research Funding; Sysmex: Research Funding; Symphogen: Membership on an entity's Board of Directors or advisory committees; BiologicTx: Research Funding; Shionogi: Membership on an entity's Board of Directors or advisory committees; Physicians Education Resource: Speakers Bureau; Protalex: Membership on an entity's Board of Directors or advisory committees, Research Funding; Immunomedics: Research Funding; Rigel Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Research Funding; Boehringer Ingelheim: Research Funding; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; UpToDate: Patents & Royalties; Momenta Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Prophylix Pharma: Membership on an entity's Board of Directors or advisory committees, Research Funding; Genzyme: Research Funding; Eisai: Membership on an entity's Board of Directors or advisory committees, Research Funding; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding. Haley:Baxalta: Membership on an entity's Board of Directors or advisory committees; CSL Behring: Honoraria. Neufeld:Novartis: Consultancy.

Evaluation of a bundle to prevent ventilator-associated pneumonia in an intensive care unit

We aimed at evaluating compliance with a bundle to prevent ventilator-associated pneumonia in an Intensive Care Unit. It is a quantitative, descriptive and cross-sectional study, conducted in a public hospital in the state of Santa Catarina. Data were collected in July and August of 2012. The sample consisted of 1,146 observations of the four elements that compose the bundle (head of bed elevation between 30-45°; endotracheal suctioning; cuff pressure between 20-30 cmH2O; and oral care with 0.12% chlorhexidine). Expected compliance was equal to a positivity rate ≥80%. Data analysis revealed overall bundle compliance of 794 (69.2%). When analyzed separately, two practices presented expected compliance (84.7%): oral care and suctioning. Head of bed elevation had the lowest compliance (55.5%), followed by cuff pressure (61.8%). We observed the need for strategies that promote the quality of all the elements that compose the bundle in order for its use to be effective.