A nursing interface terminology: evaluation of face validity

A range of different language systems for nursing diagnosis, interventions and outcomes are currently available. Nursing terminologies are intended to support nursing practice but they have to be evaluated. This study aims to assess the results of an expert survey to establish the face validity of a nursing interface terminology. The study applied a descriptive design with a cross-sectional survey strategy using a written questionnaire administered to expert nurses working in hospitals. Sample size was estimated at 35 participants. The questionnaire included topics related to validity and reliability criteria for nursing controlled vocabularies described in the literature. Mean global score and criteria scoring at least 7 were considered main outcome measures. The analysis included descriptive statistics with a confidence level of 95%. The mean global score was 8.1. The mean score for the validity criteria was 8.4 and 7.8 for reliability and applicability criteria. Two of the criteria for reliability and applicability evaluation did not achieve minimum scores. According to the experts" responses, this terminology meets face validity, but that improvements are required in some criteria and further research is needed to completely demonstrate its metric properties.

The validity and 4-year test-retest reliability of the Brazilian version of the Eating Attitudes Test-26

In a cross-sectional study conducted four years ago to assess the validity of the Brazilian version of the Eating Attitudes Test-26 (EAT-26) for the identification of abnormal eating behaviors in a population of young females in Southern Brazil, 56 women presented abnormal eating behavior as indicated by the EAT-26 and the Edinburgh Bulimic Investigation Test. They were each matched for age and neighborhood to two normal controls (N = 112) and were re-assessed four years later with the two screening questionnaires plus the Composite International Diagnostic Interview (CIDI). The EAT results were then compared to diagnoses originating from the CIDI. To evaluate the temporal stability of the two screening questionnaires, a test-retest design was applied to estimate kappa coefficients for individual items. Given the prevalence of eating disorders of 6.2%, the CIDI psychiatry interview was applied to 161 women. Of these, 0.6% exhibited anorexia nervosa and 5.6%, bulimia nervosa (10 positive cases). The validity coefficients of the EAT were: 40% sensitivity, 84% specificity, and 14% positive predictive value. Cronbach's coefficient was 0.75. For each EAT item, the kappa index was not higher than 0.344 and the correlation coefficient was lower than 0.488. We conclude that the EAT-26 exhibited low validity coefficients for sensitivity and positive predictive value, and showed a poor temporal stability. It is reasonable to assume that these results were not influenced by the low prevalence of eating disorders in the community. Thus, the results cast doubts on the ability of the EAT-26 test to identify cases of abnormal eating behaviors in this population.

A systematic observation of hostile aggression in Junior B hockey

Aggressive behaviours within the sport of hockey appear to be increasing in both prevalence and consequence (Biasca, Wirth, & Tegner, 2002). Accordingly, this area of inquiry is currently garnering a considerable amount of attention from society and academics alike. The problem however, is that our current understanding of these behaviours has been deemed both incomplete and unreliable. The inconsistencies inherent within this body of knowledge have been traced back to a variety of methodological shortcomings. The purpose of this investigation was to assess hostile aggression using a more ecologically valid and comprehensive research design. Ten Junior B hockey games were tapped and subsequently coded by three independent observers, using a validated operational list. Two hundred and fifty-nine behaviours were extrapolated and examined according to the score differential, period, position of the aggressor, status of the aggressor's team, and whether the aggressor was a member of the home or visiting team. It was concluded that the frequency of aggressive behaviours significantly differed according to the score differential, and status of the aggressor's team (p < .01). However, these hostile acts did not differ according the aggressor's position, period, and the home versus away status of the aggressor's team (p > .01). It was also determined that the majority of aggressive acts (69.1 1%) across these ten games went unsanctioned. This highlights the profound influence that "positive misses" have on penalty measures of aggression, while concurrently highlighting the ecological validity present with observational designs. Consequently, by assessing aggressive behaviour in a more inclusive and ecologically valid manner, a more accurate picture of the frequency and distribution of hostile aggression may be provided.

Politics in extraordinary times : a study of the reaction of political parties and elites to terrorism

Cette thèse porte sur le comportement des élites politiques durant les périodes de crise nationale et plus particulièrement sur leurs réactions aux attentats terroristes. Elle démontre que les crises terroristes sont tout comme les conflits militaires ou diplomatiques propices aux unions nationales et notamment aux ralliements des partis d’opposition auprès du gouvernement. L’analyse statistique d’actes terroristes s’étant produits dans cinq états démocratiques (Allemagne, Espagne, États-Unis d’Amérique, France et Royaume-Uni) entre 1990 et 2006 révèle que l’ampleur d’un attentat en termes de pertes humaines ainsi que la répétition de ces attentats influencent dans une large mesure la réaction des élites politiques. Ainsi plus l’ampleur d’un attentat est élevée, plus la probabilité d’un ralliement est grande. En revanche, la multiplication des attentats augmente la possibilité de dissension entre l’opposition et le gouvernement. Par ailleurs, l’opposition est plus susceptible de se rallier au gouvernement lorsque l’attentat est perpétré par des terroristes provenant de l’étranger. L’analyse quantitative indique également que l’existence d’un accord formel de coopération dans la lutte antiterroriste entre le gouvernement et l’opposition favorise l’union des élites. Enfin, les données analysées suggèrent que la proportion des ralliements dans les cinq pays est plus importante depuis les attentats du 11 septembre 2001. Une analyse qualitative portant exclusivement sur la France et couvrant la période 1980-2006 confirme la validité des variables identifiées dans la partie quantitative, mais suggère que les élites réagissent au nombre total de victimes (morts mais aussi blessés) et que la répétition des actes terroristes a moins d’impact lors des vagues d’attentats. Par ailleurs, les analyses de cas confirment que les élites politiques françaises sont plus susceptibles de se rallier quand un attentat vise un haut-fonctionnaire de l’État. Il apparaît également que les rivalités et rancœurs politiques propre à la France (notamment suite à l’arrivée de la gauche au pouvoir en 1981) ont parfois empêché le ralliement des élites. Enfin, cette analyse qualitative révèle que si l’extrême gauche française soutient généralement le gouvernement, qu’il soit de gauche ou de droite, en période de crise terroriste, l’extrême droite en revanche saisit quasi systématiquement l’opportunité offerte par l’acte terroriste pour critiquer le gouvernement ainsi que les partis de l’establishment. La thèse est divisée en sept chapitres. Le premier chapitre suggère que le comportement des élites politiques en période de crises internationales graves (guerres et conflits diplomatiques) est souvent influencé par la raison d’État et non par l’intérêt électoral qui prédomine lors des périodes plus paisibles. Le second chapitre discute du phénomène terroriste et de la littérature afférente. Le troisième chapitre analyse les causes du phénomène d’union nationale, soumet un cadre pour l’analyse de la réaction des élites aux actes terroristes, et présente une série d’hypothèses. Le quatrième chapitre détaille la méthodologie utilisée au cours de cette recherche. Les chapitres cinq et six présentent respectivement les résultats des analyses quantitatives et qualitatives. Enfin, le chapitre sept conclut cette thèse en résumant la contribution de l’auteur et en suggérant des pistes de recherche.

“Superficial Water Concessions In Light Of The General Theory of the Administrative Act” The Incidence of the Public Law’s Dogmatic Tradition of Public Law Within Environmental Law

This paper seeks the determine the ways in which anomalous decisions derived from the particularization and constitutionalization of environmental law can arise given the general theory of administrative action. This is seen through the lens of a study and characterization of administrative decisions issued by the Regional Autonomous Corporation of Cundinamarca –CAR- within the superficial water concessions procedure. It also discusses the conceptual contents of these licenses.

La presión laboral tendenciosa (Mobbing)

El trabajo de investigación surge en el año 2001, ante la necesidad de hacer frente a una nueva realidad jurídica, el mobbing. Para ello fue decisivo el estudio de lo publicado (básicamente de ramas ajenas al Derecho) pero sobre todo las entrevistas con las víctimas de mobbing y sus asociaciones; este extremo, unido a la ausencia de un tratamiento internacional, obligó a un camino autodidacta para definir mobbing jurídicamente. La Tesis define mobbing como la presión laboral tendente a la autoeliminación de un trabajador mediante su denigración (presión laboral tendenciosa), y con ello por primera vez se tiene una definición de mobbing en línea y media, con plena validez jurídica, que es susceptible de ser memorizada y por lo tanto divulgada, para corregir el problema. El denominado "concepto uniformado de mobbing" recalca la denigración como mecanismo frente a los tratos degradantes y recalca la autoeliminación como finalidad de un comportamiento doloso. El trabajo aporta fórmulas para deslindar casos de mobbing de otras figuras próximas, y en este sentido debe citarse "la regla del 9" para saber si hay mobbing; en sede de estadísticas se critican metodológicamente muchas de ellas presentadas hasta el momento y se aporta alguna en sede de Tribunales; pero sobre todo se advierte de los riesgos jurídicos de una previsible regulación específica antimobbing, mediante el examen de las distintas definiciones que se han esgrimido hasta el momento. La segunda parte de la Tesis profundiza sobre el grado de sensibilización de nuestro ordenamiento jurídico y Tribunales, a cuyo fin se ha trabajado con más de un centernar y medio de sentencias dictadas sobre la materia, y por supuesto la totalidad de las recogidas en las bases de datos de las editoriales. El análisis sirve para apreciar la bondad de la sistemática aquí defendida, poniendo en evidencia errores, y contradicciones. La Tesis advierte que la presión laboral tendenciosa más allá de vulnerar el derecho constitucional al trabajo, o los derechos fundamentales a la integridad moral y el honor, es una transgresión a todo un "espíritu constitucional", y en este sentido se analiza con detalle tanto la posibilidad de recurrir en amparo, como el derecho a la indemnidad para quien se enfrenta a esta situación. Advirtiendo de las ventajas de efectuar esta reacción mediante la modalidad procesal de tutela de los derechos fundamentales, se analiza la recurrida acción del art.50 ET, donde se realizan aportaciones sugerentes como el plazo prescripción o la "doctrina de los antecedentes", y se otorgan respuestas a las preguntas sobre obligación de seguir trabajando y ejecución provisional. En sede de acciones de Seguridad Social, la Tesis distingue entre la incapacidad temporal y permanente (depresiones) y la muerte y supervivencia, aportándose sobre la primera la técnica denominada "interpretación en tres niveles" y descartando la posibilidad de considerar accidente de trabajo el suicidio tras un mobbing por imperativo legal, pero aportando un sucedáneo bastante razonable como es el accidente no laboral. Junto a ello se razona por la viabilidad del recargo del art.123 LGSS. Civilmente, la Tesis se posiciona de "lege ferenda" por reconducir este tipo de acciones resarcitorias del daño psíquico y moral al orden civil, por una mayor explicación sobre el origen del quantum, pero sobre todo considera inadmisible la STS 11-3-04, y ello por una pluralidad de argumentos, pero sobre todo por cuanto viene a autorizar "de facto" este tipo de conductas. La posibilidad de accionar administrativamente frente a este riesgo psicosocial se analiza en un doble terreno, la empresa y la Administración. Si bien el cauce sobre el primero tiene algunos meandros que se desbelan, la situación es radicalmente frustrante en la Administración -donde se encuentra el mayor caldo de cultivo del mobbing- , y ello por el RD 707/2002, pero todavía en mayor medida por el Criterio Técnico 34/2003 mediante el cual la interpretación del Director General de la Inspección de Trabajo y Seguridad Social ha venido tácitamente a derogar parcialmente la Ley de Prevención de Riesgos Laborales para la Administración. En materia penal, la Tesis se decanta "a priori" por dos tipos penales, los delitos contra los derechos de los trabajadores, y el delito de trato degradante; sin embargo, en la práctica sólo este segundo es el camino que puede alcanzar buen puerto. Finalmente se realiza un estudio detallado de la Ley 62/2003, ley que se divulgó como reguladora del acoso moral, y que después se defiende como un avance frente al mobbing. La Tesis advierte que no es cierto ni lo uno, ni lo otro, habiendo creado un "espejismo legal" que puede perjudicar a las víctimas de mobbing, además de no servir su estructura para una futura regulación explícita antimobbing.

Validity and reproducibility of a laser fluorescence system for detecting the activity of white-spot lesions on free smooth surfaces in vivo

The aim of the study was to determine the reproducibility and validity of DIAGNOdent in detecting active and arrested caries lesions on free smooth surfaces. Volunteers were selected from state schools of Piracicaba, São Paulo, Brazil. Overall, 220 lesions were clinically examined. Two specially trained ('calibrated') examiners performed both clinical and laser evaluations independently, and after a 1-week interval, the examinations were repeated, the intra-examiner agreement for the laser evaluation was substantial (kappa(ex1) = 0.79, kappa(ex2) = 0.71). There was almost perfect agreement between the two examiners for the clinical examination (kappa(ex1) = 0.95, kappa(ex2) = 0.85). The inter-examiner agreement showed substantial reproducibility (kappa = 0.77) for the laser examination and almost perfect agreement (kappa = 0.85) for the clinical evaluation. The validation criterion was the clinical examination of white spots, recorded as active or arrested. The sensitivity was 0.72 and the specificity was 0.73, which indicates that the DIAGNOdent was a good auxiliary method for detecting incipient caries lesions on free smooth surfaces. The utilization of both methods can improve the efficacy of caries diagnosis. Copyright (C) 2002 S. Karger AG, Basel.

Validity and reliability of the Portuguese version of Mandibular Function Impairment Questionnaire

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The Brazilian version of the Neuropsychiatric Inventory-Clinician rating scale (NPI-C): Reliability and validity in dementia

ABSTRACT Background: Patients with dementia may be unable to describe their symptoms, and caregivers frequently suffer emotional burden that can interfere with judgment of the patient's behavior. The Neuropsychiatric Inventory-Clinician rating scale (NPI-C) was therefore developed as a comprehensive and versatile instrument to assess and accurately measure neuropsychiatric symptoms (NPS) in dementia, thereby using information from caregiver and patient interviews, and any other relevant available data. The present study is a follow-up to the original, cross-national NPI-C validation, evaluating the reliability and concurrent validity of the NPI-C in quantifying psychopathological symptoms in dementia in a large Brazilian cohort. Methods: Two blinded raters evaluated 312 participants (156 patient-knowledgeable informant dyads) using the NPI-C for a total of 624 observations in five Brazilian centers. Inter-rater reliability was determined through intraclass correlation coefficients for the NPI-C domains and the traditional NPI. Convergent validity included correlations of specific domains of the NPI-C with the Brief Psychiatric Rating Scale (BPRS), the Cohen-Mansfield Agitation Index (CMAI), the Cornell Scale for Depression in Dementia (CSDD), and the Apathy Inventory (AI). Results: Inter-rater reliability was strong for all NPI-C domains. There were high correlations between NPI-C/delusions and BPRS, NPI-C/apathy-indifference with the AI, NPI-C/depression-dysphoria with the CSDD, NPI-C/agitation with the CMAI, and NPI-C/aggression with the CMAI. There was moderate correlation between the NPI-C/aberrant vocalizations and CMAI and the NPI-C/hallucinations with the BPRS. Conclusion: The NPI-C is a comprehensive tool that provides accurate measurement of NPS in dementia with high concurrent validity and inter-rater reliability in the Brazilian setting. In addition to universal assessment, the NPI-C can be completed by individual domains. © International Psychogeriatric Association 2013.

Severity of temporomandibular disorders in women: validity and reliability of the Fonseca Anamnestic Index

The aim of this study was to assess the validity and reliability of the Fonseca Anamnestic Index (IAF), used to assess the severity of temporomandibular disorders, applied to Brazilian women. We used a probabilistic sampling design. The participants were 700 women over 18 years of age, living in the city of Araraquara (SP). The IAF questionnaire was applied by telephone interviews. We conducted Confirmatory Factor Analysis (CFA) using Chi-Square Over Degrees of Freedom (χ2/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA) as goodness of fit indices. We calculated the convergent validity, the average variance extracted (AVE) and the composite reliability (CR). Internal consistency was assessed by Cronbach's alpha coefficient (α).The factorial weights of questions 8 and 10 were below the adequate values. Thus, we refined the original model and these questions were excluded. The resulting factorial model showed appropriate goodness of fit to the sample (χ2/df = 3.319, CFI = 0.978, TLI = 0.967, RMSEA = 0.058). The convergent validity (AVE = 0.513, CR = 0.878) and internal consistency (α = 0.745) were adequate. The reduced IAF version showed adequate validity and reliability in a sample of Brazilian women.

Rapid turbidimetric assay to potency evaluation of tigecycline in lyophilized powder

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

THE CURRENT STATUS OF PLAGUE IN CALIFORNIA

At the first Vertebrate Pest Control Conference in 1964, I traced the history of plague control in California and outlined a revised approach, based on newer concepts of plague ecology. In our state of relative ignorance, this required a number of unproved assumptions about plague occurrence in California that verged on crystal ball gazing. These were principally that (1) plague persists in relatively resistant rodent species in certain favorable locations, (2) ground squirrels and chipmunks experience periodic epizootics, but are not permanent reservoirs, (3) plague "foci" of the past were merely sites of conspicuous epizootics, they did not necessarily correspond to permanent foci, and could result from epizootic migrations over considerable distances, and (4) a number of assumptions about areas of greatest epizootic potential can be made by analyzing the pattern of recurrent plague outbreaks in the past. Since then the validity of these assumptions has been tested by the largest outbreak of plague since the early 1940's. We believe that the results have proved the crystal ball largely correct, resulting in much more precise and efficient epizootic surveillance and deployment of control measures than in the past. The outbreak was for us an administrative emergency that exceeded the capacities of the State Health Department. We greatly appreciated the vital help and cooperation of other agencies and individuals. The U.S, Public Health Service accepted a heavy burden of laboratory testing through its San Francisco Field Station, and provided emergency field personnel. The contributions of State Department of Agriculture, Bureau of Weed and Vertebrate Pest Control; U.S. Parks, Forest Service and Bureau of Land Management; local health and agriculture department; and State Division of Parks personnel were essential in accomplishing control work, as well as epizootic surveillance.

A Validity Study of the Short Portable Mental Status Questionnaire

The short, portable mental status questionnaire (SPMSQ) developed by Pfeiffer has several advantages over previous short instruments designed to assess the intellectual functioning of older adults. It is based upon data from both institutionalized and community-dwelling elderly. Although Pfeiffer a four-group classification, he used to groups in his initial validation study: (a) intact/mildly impaired, and (b) moderately/severely impaired. The present study compared clinicians' ratings with those based upon the SPMSQ scores, and examined the validity of the four-group classification. The sample included 181 subjects from seven intermediate care facilities and nine home-care agencies. All were assessed by the OARS questionnaire, which includes the SPMSQ Three discriminant analyses were performed with three different criteria, for two-group, three-group, and four-group models. Results indicated that the two-group model (intact/mildly impaired and moderately/severely impaired) permitted significant discrimination. The four-group model, however, gave less distinct results. In particular, patients who were mildly intellectually impaired could not be clearly distinguished from those who were intact and from those who were moderately impaired. The three-group model (minimally, moderately, severely impaired) seemed to offer the best compromise between the gross dichotomy of the original two-model system and the less accurate four category system.

Validity evidence and reliability of a Simulated Patient Feedback Instrument

In the training of healthcare professionals, one of the advantages of communication training with simulated patients (SPs) is the SP's ability to provide direct feedback to students after a simulated clinical encounter. The quality of SP feedback must be monitored, especially because it is well known that feedback can have a profound effect on student performance. Due to the current lack of valid and reliable instruments to assess the quality of SP feedback, our study examined the validity and reliability of one potential instrument, the 'modified Quality of Simulated Patient Feedback Form' (mQSF). Methods Content validity of the mQSF was assessed by inviting experts in the area of simulated clinical encounters to rate the importance of the mQSF items. Moreover, generalizability theory was used to examine the reliability of the mQSF. Our data came from videotapes of clinical encounters between six simulated patients and six students and the ensuing feedback from the SPs to the students. Ten faculty members judged the SP feedback according to the items on the mQSF. Three weeks later, this procedure was repeated with the same faculty members and recordings. Results All but two items of the mQSF received importance ratings of > 2.5 on a four-point rating scale. A generalizability coefficient of 0.77 was established with two judges observing one encounter. Conclusions The findings for content validity and reliability with two judges suggest that the mQSF is a valid and reliable instrument to assess the quality of feedback provided by simulated patients.

The Constitutional-Judicial Control of the Legislative and Executive Powers in Central and Eastern European Countries

This project looked at the nature, contents, methods, means and legal and political effects of the influence that constitutional courts exercise upon the legislative and executive powers in the newly established democracies of Central and Eastern Europe. The basic hypothesis was that these courts work to provide a limitation of political power within the framework of the principal constitutional values and that they force the legislature and executive to exercise their powers and duties in strict accordance with the constitution. Following a study of the documentary sources, including primarily the relevant constitutional and statutory provisions and decisions of constitutional courts, Mr. Cvetkovski prepared a questionnaire on various aspects of the topics researched and sent it to the respective constitutional courts. A series of direct interviews with court officials in six of the ten countries then served to clarify a large number of questions relating to differences in procedures etc. that arose from the questionnaires. As a final stage, the findings were compared with those described in recent publications on constitutional control in general and in Central and Eastern Europe in particular. The study began by considering the constitutional and political environment of the constitutional courts' activities in controlling legislative and executive powers, which in all countries studied are based on the principles of the rule of law and the separation of powers. All courts are separate bodies with special status in terms of constitutional law and are independent of other political and judicial institutions. The range of matters within their jurisdiction is set by the constitution of the country in question but in all cases can be exercised only with the framework of procedural rules. This gives considerable significance to the question of who sets these rules and different countries have dealt with it in different ways. In some there is a special constitutional law with the same legal force as the constitution itself (Croatia), the majority of countries allow for regulation by an ordinary law, Macedonia gives the court the autonomy to create and change its own rules of procedure, while in Hungary the parliament fixes the rules on procedure at the suggestion of the constitutional court. The question of the appointment of constitutional judges was also considered and of the mechanisms for ensuring their impartiality and immunity. In the area of the courts' scope for providing normative control, considerable differences were found between the different countries. In some cases the courts' jurisdiction is limited to the normative acts of the respective parliaments, and there is generally no provision for challenging unconstitutional omissions by legislation and the executive. There are, however, some situations in which they may indirectly evaluate the constitutionality of legislative omissions, as when the constitution contains provision for a time limit on enacting legislation, when the parliament has made an omission in drafting a law which violates the constitutional provisions, or when a law grants favours to certain groups while excluding others, thereby violating the equal protection clause of the constitution. The control of constitutionality of normative acts can be either preventive or repressive, depending on whether it is implemented before or after the promulgation of the law or other enactment being challenged. In most countries in the region the constitutional courts provide only repressive control, although in Hungary and Poland the courts are competent to perform both preventive and repressive norm control, while in Romania the court's jurisdiction is limited to preventive norm control. Most countries are wary of vesting constitutional courts with preventive norm control because of the danger of their becoming too involved in the day-to-day political debate, but Mr. Cvetkovski points out certain advantages of such control. If combined with a short time limit it can provide early clarification of a constitutional issue, secondly it avoids the problems arising if a law that has been in force for some years is declared to be unconstitutional, and thirdly it may help preserve the prestige of the legislation. Its disadvantages include the difficulty of ascertaining the actual and potential consequences of a norm without the empirical experience of the administration and enforcement of the law, the desirability of a certain distance from the day-to-day arguments surrounding the political process of legislation, the possible effects of changing social and economic conditions, and the danger of placing obstacles in the way of rapid reactions to acute situations. In the case of repressive norm control, this can be either abstract or concrete. The former is initiated by the supreme state organs in order to protect abstract constitutional order and the latter is initiated by ordinary courts, administrative authorities or by individuals. Constitutional courts cannot directly oblige the legislature and executive to pass a new law and this remains a matter of legislative and executive political responsibility. In the case of Poland, the parliament even has the power to dismiss a constitutional court decision by a special majority of votes, which means that the last word lies with the legislature. As the current constitutions of Central and Eastern European countries are newly adopted and differ significantly from the previous ones, the courts' interpretative functions should ensure a degree of unification in the application of the constitution. Some countries (Bulgaria, Hungary, Poland, Slovakia and Russia) provide for the constitutional courts' decisions to have a binding role on the constitutions. While their decisions inevitably have an influence on the actions of public bodies, they do not set criteria for political behaviour, which depends rather on the overall political culture and traditions of the society. All constitutions except that of Belarus, provide for the courts to have jurisdiction over conflicts arising from the distribution of responsibilities between different organs and levels in the country, as well for impeachment procedures against the head of state, and for determining the constitutionality of political parties (except in Belarus, Hungary, Russia and Slovakia). All the constitutions studied guarantee individual rights and freedoms and most courts have jurisdiction over complaints of violation of these rights by the constitution. All courts also have some jurisdiction over international agreements and treaties, either directly (Belarus, Bulgaria and Hungary) before the treaty is ratified, or indirectly (Croatia, Czech Republic, Macedonia, Romania, Russia and Yugoslavia). In each country the question of who may initiate proceedings of norm control is of central importance and is usually regulated by the constitution itself. There are three main possibilities: statutory organs, normal courts and private individuals and the limitations on each of these is discussed in the report. Most courts are limited in their rights to institute ex officio a full-scale review of a point of law, and such rights as they do have rarely been used. In most countries courts' decisions do not have any binding force but must be approved by parliament or impose on parliament the obligation to bring the relevant law into conformity within a certain period. As a result, the courts' position is generally weaker than in other countries in Europe, with parliament remaining the supreme body. In the case of preventive norm control a finding of unconstitutionality may act to suspend the law and or to refer it back to the legislature, where in countries such as Romania it may even be overturned by a two-thirds majority. In repressive norm control a finding of unconstitutionality generally serves to take the relevant law out of legal force from the day of publication of the decision or from another date fixed by the court. If the law is annulled retrospectively this may or may not bring decisions of criminal courts under review, depending on the provisions laid down in the relevant constitution. In cases relating to conflicts of competencies the courts' decisions tend to be declaratory and so have a binding effect inter partes. In the case of a review of an individual act, decisions generally become effective primarily inter partes but is the individual act has been based on an unconstitutional generally binding normative act of the legislature or executive, the findings has quasi-legal effect as it automatically initiates special proceedings in which the law or other regulation is to be annulled or abrogated with effect erga omnes. This wards off further application of the law and thus further violations of individual constitutional rights, but also discourages further constitutional complaints against the same law. Thus the success of one individual's complaint extends to everyone else whose rights have equally been or might have been violated by the respective law. As the body whose act is repealed is obliged to adopt another act and in doing so is bound by the legal position of the constitutional court on the violation of constitutionally guaranteed freedoms and rights of the complainant, in this situation the decision of the constitutional court has the force of a precedent.