Timing Of Notification Research Articles

The risk of insomnia by work schedule instability in Korean firefighters.

Firefighters are exposed to shift work, as well as unpredictable emergency calls and traumatic events, which can lead to sleep problems. This study aimed to investigate the risk of insomnia by work schedule instability in Korean firefighters. This study used the Insomnia Severity Index to assess the insomnia in firefighters. The work schedule stability was classified with the frequency of the substitute work and the timing of notification for work schedule changes. Logistic regression analysis was used to assess the adjusted odds ratio of insomnia by work schedule stability with covariates including sex, age, education, smoking, alcohol, caffeine intake, shift type, job, and underlying conditions. Of the 8,587 individuals, 751 (8.75%) had moderate to severe insomnia (Insomnia Severity Index ≥ 15). The prevalence of insomnia was statistically significantly higher as the frequency of substitute work increased: <1 time per month (6.8%), 1-2 times (9.5%), 3-5 times (13.4%), and more than 5 times (15.7%) (p < 0.001). Additionally, the prevalence of insomnia was statistically significantly higher when the timing of the schedule change notification was urgent or irregular: no change or several weeks before (5.4%), several days before (7.9%), one day before or on the day (11.2%), irregularly notification (11.6%) (p < 0.001). In comparison to the group with good frequency of the substitute work/good timing of schedule change notification group, the adjusted odds ratios of insomnia were 1.480 (95% confidence interval [CI]: 1.237-1.771) for Good/Bad group, 1.862 (95% CI: 1.340-2.588) for Bad/Good group, and 1.885 (95% CI: 1.366-2.602) for Bad/Bad group. Work schedule instability was important risk factor of insomnia in firefighters. It suggests that improving the stability of work schedules could be a key strategy for reducing sleep problems in this occupational group.

Labor supply response to overpayment notifications: Evidence from Social Security Disability Insurance

AbstractWe use administrative data to provide evidence that notification of work‐related overpayment debt reduces subsequent work activity by Social Security Disability Insurance beneficiaries. We exploit randomness in the timing of the overpayment debt notification by comparing beneficiary work activity before and after notification. Our results show that the share of overpaid beneficiaries engaging in substantial work activity declined by 8% over the 2‐month period following an overpayment notification, which reduced to 4% after accounting for the ongoing declining trend in work activity. This evidence that overpayment debt notification discourages work highlights the need for policies to curtail overpayments.

Force Majeure For Contract Agreement

Agricultural production is an activity characterized by a high degree of risk. First of all it is caused by unpredictability of weather conditions and natural disasters. In addition, armed conflict in eastern Ukraine, annexation of the Crimea, strikes, industrial accidents - all these conditions affect the quantity and quality of products, as well as the timing of fulfillment of obligations.&#x0D; Therefore, the topic of force majeure is extremely relevant to agricultural producers, as a basis for exemption from liability for failure or improper performance of the contract.&#x0D; The onset of force majeure is the basis for the release of the guilty person from responsibility for non-fulfillment (breach) of its contractual obligation, tract, agreement. At the same time, the onset of force majeure must be duly certified (verified) in accordance with compliance with the provisions of the current legislation of Ukraine and the terms of the agreement thief, as one party to the contract may require the other payment of penalties (in case of improperly confirmed-whether or not confirmation of the occurrence of force majeure). List of circumstances of force majeure and their order confirmation is agreed by the parties directly in the contractri. Often the parties assume that the evidence of force majeure The Chamber of Commerce and Industry of Ukraine implements the most serious circumstances&#x0D; The article is dedicated to understanding “force majeure” and “excessive power” as well as to the specificities of the contract for the contractual contract for the nonnegotiable settlement of the contract.&#x0D; Therefore, in order to prevent the parties to the contractual contraction from possible negative situations in the future, it is necessary to determine from the outset what the circumstances will be considered as force majeure, what will confirm the occurrence of such circumstance, the timing of notification of the other party about such circumstances, etc.

Assisted partner notification services for patients receiving HIV care and treatment in an HIV clinic in Nairobi, Kenya: a qualitative assessment of barriers and opportunities for scale-up.

IntroductionIdentifying HIV‐positive individuals is increasingly recognized as one of the most important and most challenging of the UNAIDS 90‐90‐90 goals. Assisted partner notification services (aPNS) involves tracing and offering HIV testing to partners of HIV‐positive individuals, and is effective and safe when provided to newly diagnosed HIV‐positive patients. Voluntary aPNS is now part of the World Health Organization's guidelines for HIV prevention and care. However, uptake of aPNS is significantly lower among adults with established HIV infection already engaged in care compared to newly diagnosed individuals. We sought to describe barriers encountered and potential opportunities to providing aPNS to established patients living with HIV.MethodsWe conducted focus group discussions and in‐depth interviews at Nairobi's largest public HIV clinic in April to May 2016 to elucidate barriers to and opportunities for aPNS among established patients engaged in HIV care. Participants included HIV‐positive adults in care, their partners, and healthcare workers (HCWs). Qualitative data analysis took a grounded theory approach.ResultsBarriers to aPNS fell under three main categories. Fear of disclosure to partners included concerns over relationship repercussions, loss of trust, blame and violence. Stigma and discrimination were described in the healthcare setting, at church and in general society. Participants described difficulties approaching communication, including cultural barriers and differences in education. For almost every barrier a potential solution was also identified, and a barrier‐opportunity relationship emerged. Opportunities included using couples testing centres to aid in disclosure, focusing on the ambiguous introduction of the infection, and sensitization of HCWs and community leaders.ConclusionsaPNS among established HIV patients is associated with different barriers and opportunities than aPNS among newly diagnosed patients, and HCWs should build their capacity to support aPNS in this population. There is a strong need for increased training and sensitization on the use of aPNS in different circumstances and for different clients, taking into consideration factors such as timing of partner notification, characteristics of the relationship and duration of knowledge discordance. The overall success of this intervention among populations living with HIV may rely on customization of services and key messages to meet the patients’ specific needs.

Preventing unintentional injuries in US early care and education: Are state regulations sufficient?

Unintentional injuries are currently the leading cause of death among US children older than one. As many children spend significant time in non-parental child care, these injuries often occur outside of the home. This study examined US state early care and education (ECE) regulations related to injury prevention. We reviewed ECE regulations for child care centers and family child care homes through August 2018 for all 50 states and DC (“states”). We compared these regulations to six components from two national health and safety standards on injury prevention (“standards”). One state had regulations that met all six standards for both centers and homes; sixteen states had regulations that met at least five for both. Most states required child care providers to be trained in emergency preparedness (42 for centers; 38 for homes) or first aid including CPR (50 for centers; 46 for homes). Additionally, most states required providers in centers and homes to notify parents (47 and 41, respectively) and the state (40 and 41, respectively) when a child was injured; these requirements varied greatly in both the timing and manner of notification. Two-thirds of states required that providers keep copies of a completed injury form on the premises. However, few states (5 for centers, 3 for homes) required providers to take corrective action after an injury. Although most states had some injury prevention regulations, they varied greatly across states. More states should require corrective action after an injury to help prevent future injuries from occurring.

The earlier, the better? Diagnostic experiences of parents in a community-based early intervention system for preschool children with autism

Background and aims In many countries, early detection and diagnosis of autism spectrum disorder is largely dependent on parents’ initial concern with early symptoms of autism spectrum disorder. Previous research on parental perceptions of the autism spectrum disorder diagnostic process indicates that parental satisfaction may be due to either the timing of the diagnostic notification or the provision of post-diagnostic support. The objective of this research is to study the diagnostic notification process and its impact on parents who are informed of their young child’s diagnosis before they notice a problem and whose child undergoes early intervention therapy. Methods Eighty parents of preschool children diagnosed and undergoing early intervention for autism were surveyed to examine their experience of the diagnostic disclosure process. Results Of 68 respondents, 39 (58.2%) approved of the timing of diagnostic notification, while 10 of 13 dissatisfied respondents indicated that the diagnosis was communicated too late. However, there was no correlation between a higher degree of parental satisfaction with the diagnostic notification process and earlier timing of notification. Conclusions Although it is preferable to communicate a diagnosis of childhood autism as soon as possible, findings suggest that a highly individualized approach, allowing a degree of latitude in the timing of notification, may be permissible, depending on the individual case and parental readiness to receive the diagnosis. Implications Findings have clinical implications related to the concept of optimality of diagnostic disclosure as related to the diagnostic notification process, though later notification tends to lead to more dissatisfaction.

Patient and Physician Experience with Interhospital Transfer: A Qualitative Study.

Although existing data suggest marked variability in interhospital transfer (IHT), little is known about specific factors that may impact the quality and safety of this care transition. We aimed to explore transferred patients' and involved physicians' experience with IHT to better understand the components of the transfer continuum and identify potential targets for improvement. We performed a qualitative study using individual interviews of adult patients recently transferred to cardiology, general medicine, and oncology services at a tertiary care academic medical center, as well as their transferring physician, accepting attending physician, and accepting/admitting resident physician. We conducted a thematic analysis, using an inductive approach and an a priori framework from pre-established domains. Participants included 10 hospitalized adults (6 cardiology, 2 general medicine, and 2 oncology), 9 accepting attending physicians, 12 accepting and/or admitting resident physicians, and 5 transferring physicians (N = 36). Emergent themes demonstrated that participants held a shared understanding of the reason for transfer (most commonly access to more specialized care), and relayed a general dissatisfaction regarding the timing and lack of advanced notification of transfer. We also found distinct differences in IHT experience by stakeholder group: physician participants relayed discontent with intrahospital chains of communication and interhospital information exchange, and patient participants focused more readily on the physical aspects of IHT. This study offers insight into IHT from the perspective of those most affected by this process, thereby identifying potential targets in addressing the quality and safety of this transition.

Beyond Panic: Variation in the Legislative Activity for Sex Offender Registration and Notification Laws Across States Over Time

Nationwide moral panic has long served as a primary explanation for sex offense laws. These laws, however, remain primarily left to state legislatures, which implies potential variation in their content over time. Variation in legislative content, to the degree that it represents implementation, not only suggests differential consequences for registrants and communities, but also it would raise questions to the sufficiency of moral panic as a sole explanation for sex offense policy change. I build upon earlier work by exploring variation in the content and timing of sex offender registration and notification (SORN) reform in all 50 states over time. After documenting variation in these laws, I present the ways in which SORN legislative content has evolved differently across states. In addition, the timing of legislative reforms differed not only across states but also within states over time. These findings have implications for existing theoretical assertions regarding criminal justice policy.

The Status of Parental Notification Policy and Practice for Students Involved with Alcohol Abuse at a Private University in Nigeria

Parental notification policies and practices have been found to reduce alcohol and drug use at universities in the United States of America. This study examined the status of parental notification policy and practice at a faith-based private university in Nigeria for students involved with alcohol use. The study revealed that the absence of a documented policy on procedure on parental notification led to inconsistencies in the informal notification practices. Parents, staff and students expressed varied degrees of frustration at the lack of proper parental notification practices. Factors such as mode of notification, timing and purpose of notification, clarification of familial relationships between students and parents–guardian emerged as key indicators. The study recommends that Nigeria as a nation contextualize the American Higher Education Reauthorization Act of 1998 and enact legislation on parental notification that will inform the development of a parental notification policy in Nigerian universities.

Issuers obligations under the new Market Abuse Regulation and the proposed ESMA guideline regime: a brief overview

Abstract The present work briefly analyses some selected topics of the new European Market Abuse framework, in particular with reference to issuers’ obligations. The package of the reform originally proposed by the Commission on 2011 was composed of two legislative proposals: (i) a regulation on insider dealing and market manipulation which is going to replace directive 2003/6/EC and its implementing measures; and (ii) a directive specifically concerning criminal sanctions for insider dealing and market manipulation. The work takes into consideration the text of the regulation adopted by the European Parliament in its plenary setting on September, 10th, 2013 and the ESMA’s Discussion Paper published in November 2013. Paragraph II deals with the critical notion of inside information for the purpose of insider trading and for issuers’ duty to disclose, underlining ESME’s approach with reference to the twofold notion of inside information in the directive 2003/6/EC and examining the definition of art. 6 of the new regulation in the light of the decision of the European Court of Justice in the case Marcus Geltl against Daimler AG. ThereTherefore fore, it analyses the marginal utility of the delay as a remedy for the communication of information not sufficiently mature and the importance of the ESMA’ s guidelines for the definition of the conditions of the delay. The new rules on rumours and market soundings, never tackled in the directive 2003/6/EC, will be also commented. Paragraph III analyses the content and the scope of insider lists. Taking into consideration the timing of the public disclosure and the conditions for the delay set forth in art. 12, par. 3 of the proposed regulation, this work sounds out the concrete function of insider lists, especially with reference to the list of “occasional insider”, and evaluates the effectiveness of the proposed ESMA’s implementing regime. Paragraph IV deals with managers’ transactions, tackling with some specific problems such as the shortened timing of notification, the low threshold for the communication of managers’ transactions and the possibility for Member States to raise this threshold.

Critical findings: timing of notification in neuroradiology.

Timely reporting of critical findings in radiology has been identified by The Joint Commission as one of the National Patient Safety Goals. Our aim was to determine the magnitude of delays between identifying a neuroradiologic critical finding and verbally notifying the caregiver in an effort to improve clinical outcomes. We surveyed the time of critical finding discovery, attempted notification, and direct communication between neuroradiologists and caregivers for weekday, evening, overnight, and weekend shifts during an 8-week period. The data were collected by trained observers and/or trainees and included 13 neuroradiology attendings plus fellows and residents. Critical findings were based on a previously approved 17-item list. Summary and comparative t test statistics were calculated, and sources of delays were identified. Ninety-one critical findings were recorded. The mean time from study acquisition to critical finding discovery was 62.2 minutes, from critical finding discovery to call made 3.7 minutes, and from call made to direct communication, 5.2 minutes. The overall time from critical finding discovery to caregiver notification was within 10 minutes in 72.5% (66/91) and 15 minutes in 93.4% (85/91) of cases. There were no significant differences across shifts except for daytime versus overnight and weekend shifts, when means were 2.4, 5.6, and 8.7 minutes, respectively (P < .01). If >1 physician was called, the mean notification time increased from 3.5 to 10.1 minutes (P < .01). Sources of delays included inaccurate contact information, physician unavailability (shift change/office closed), patient transfer to a different service, or lack of responsiveness from caregivers. Direct communication with the responsible referring physician occurred consistently within 10-15 minutes after observation of a critical finding. These delays are less than the average interval from study acquisition to critical finding discovery (mean, 62.2 minutes).

Knowledge, attitude, and practice of dengue disease among healthcare professionals in southern Taiwan

Primary physicians and nurses serve as the first-line health care providers of dengue virus infection diagnosis, notification, and treatment. Knowledge, attitude, and practice (KAP) among primary healthcare professionals (HCPs) regarding dengue diseases may pace alarm and improve the outcome of dengue control. A cross-sectional survey using a structured quiz in 264 HCPs (response rate, 76%) was conducted in Tainan City in southern Taiwan. The quiz consisted of 10 questions regarding the control measures, notification, and clinical practices of dengue diseases. Scores of KAP and demographic characteristics of HCPs were analyzed. One hundred thirty-four physicians and 130 nurses comprise the 264 HCP responders. Forty-three physicians (32%) and 80 nurses (61.5%) were practicing in medical centers, and they scored higher than nonmedical center peers on quizzes on notification (1.18 vs. 0.93 points, p<0.01) but lower on control measures (3.52 vs. 3.22 points, p<0.01). Fifty-seven physicians (42.5%) were experienced in reporting suspected dengue cases, and 13.1% of nurses had reported dengue cases. Three-fourths of HCPs failed to respond to the timing of dengue case notification, whereas nurses scored higher than physicians (0.34 vs. 0.16, p<0.01). In addition, 57.2% of the HCPs failed to respond correctly to the timing of typical skin rashes occurring in the patients with dengue. More than half of the HCPs considered Taiwan an endemic area of dengue diseases. This pilot study showed a lack of acquaintance with notification timing and important clinical features of dengue among HCPs in southern Taiwan. Future continued medical/nursing education should place more emphasis on these factors to improve dengue control in this demographic area.

What is optimal timing for trauma team alerts? A retrospective observational study of alert timing effects on the initial management of trauma patients

BackgroundTrauma teams improve the initial management of trauma patients. Optimal timing of trauma alerts could improve team preparedness and performance while also limiting adverse ripple effects throughout the hospital. The purpose of this study was to evaluate how timing of trauma team activation and notification affects initial in-hospital management of trauma patients.MethodsData from a single hospital trauma care quality registry were matched with data from a trauma team alert log. The time from patient arrival to chest X-ray, and the emergency department length of stay were compared with the timing of trauma team activations and whether or not trauma team members received a preactivation notification.ResultsIn 2009, the trauma team was activated 352 times; 269 times met the inclusion criteria. There were statistically significant differences in time to chest X-ray for differently timed trauma team activations (P = 0.003). Median time to chest X-ray for teams activated 15–20 minutes prearrival was 5 minutes, and 8 minutes for teams activated <5 minutes before patient arrival. Timing had no effect on length of stay in the emergency department (P = 0.694). We found no effect of preactivation notification on time to chest X-ray (P = 0.474) or length of stay (P = 0.684).ConclusionProactive trauma team activation improved the initial management of trauma patients. Trauma teams should be activated prior to patient arrival.

Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review

BACKGROUNDSerious lapses in patient care result from failure to follow-up test results.OBJECTIVETo systematically review evidence quantifying the extent of failure to follow-up test results and the impact for ambulatory patients.DATA SOURCESMedline, CINAHL, Embase, Inspec and the Cochrane Database were searched for English-language literature from 1995 to 2010.STUDY SELECTIONStudies which provided documented quantitative evidence of the number of tests not followed up for patients attending ambulatory settings including: outpatient clinics, academic medical or community health centres, or primary care practices.DATA EXTRACTIONFour reviewers independently screened 768 articles.RESULTSNineteen studies met the inclusion criteria and reported wide variation in the extent of tests not followed-up: 6.8% (79/1163) to 62% (125/202) for laboratory tests; 1.0% (4/395) to 35.7% (45/126) for radiology. The impact on patient outcomes included missed cancer diagnoses. Test management practices varied between settings with many individuals involved in the process. There were few guidelines regarding responsibility for patient notification and follow-up. Quantitative evidence of the effectiveness of electronic test management systems was limited although there was a general trend towards improved test follow-up when electronic systems were used.LIMITATIONSMost studies used medical record reviews; hence evidence of follow-up action relied upon documentation in the medical record. All studies were conducted in the US so care should be taken in generalising findings to other countries.CONCLUSIONSFailure to follow-up test results is an important safety concern which requires urgent attention. Solutions should be multifaceted and include: policies relating to responsibility, timing and process of notification; integrated information and communication technologies facilitating communication; and consideration of the multidisciplinary nature of the process and the role of the patient. It is essential that evaluations of interventions are undertaken and solutions integrated into the work and context of ambulatory care delivery.

New Provisions Regarding Texas Medical Board Proceedings

New Provisions Regarding Texas Medical Board Proceedings

Communication with survivors of motor vehicle crashes

BackgroundCommunication with survivors of severe motor vehicle crashes is challenging for emergency physicians. The appropriate timing of death notification to survivors of severe motor vehicle crashes is unknown.ObjectiveTo determine communication...

Getting the Word Out: Notes on the Social Organization of Notification

Even when the timing, sequence, and manner of notification are instrumentally inconsequential, how one conveys information affects the meaning of the telling. This article introduces the concepts of “notification norms” and the “information order,” showing how the former constrain the behavior of nodes in social networks as well as enabling manipulation of the relationships that comprise those networks. “Notification” is defined as information transmission motivated by role obligations and notification norms as social rules that govern such transmission. These rules produce patterns of information dissemination different from what individual volition would yield and from what technology makes possible. The capacity to wield a socially sanctioned repertoire of notification rules is a learned competence. Competent notifiers must also understand the local epistemological ecology—the distribution and trajectory of information, as well as the projects, concerns, and priorities of one's fellows. This study of notification introduces the broader concept of “the information order” and is a first step in the project of a sociology of information.

Processes of care in cervical and breast cancer screening and follow-up—the importance of communication

Background. Given limited research, we investigated patient reports of processes of care related to screening follow-up, timing of result notification, communication issues, and adherence following an abnormal mammogram or Pap test. Methods. Women age 50 and over with an abnormal screening mammogram and women age 18 and above with an abnormal Pap test result completed surveys. The mammogram and Pap survey instruments had similar items except pertaining to measures specific to mammography or Pap tests. Bivariate associations between processes of care variables (test results, result receipt, recommendation adherence, receipt of confusing/conflicting information) and global satisfaction were explored using chi-square contingency table analysis. Multivariable logistic regression modeling was conducted. Results. One thousand one hundred thirty-four women (79.1%) completed the mammogram survey and 1087 women (69.7%) completed the Pap survey. The majority of women received test results quickly. High compliance was reported with recommendations for short-term follow-up. Conflicting/confusing information was reported by a minority of women, but was significantly and positively related to reporting that “care could be better”. Patient's lack of understanding about equivocal findings was evident. Conclusions. This study confirms that patients need clear messages about recommendations, especially when findings are equivocal and where multiple providers are involved in the process of making clinical decisions.