Cause Of Complaints Research Articles

Complications and complaints in craniofacial fractures - Finnish national data for 20years.

Research on reasons for malpractice claims in oral and maxillofacial surgery is scarce. The aim of this study was to investigate the causes and prevalence of permanent harm among craniofacial fracture related malpractice claims. A retrospective register study was designed and implemented. All patients with a complaint and a diagnosis of facial or cranial fracture were included. The main outcome was the presence of permanent harm, and the predictor variable was the cause of complaint. Chi-square test was used for estimation of statistical significance. Delay in correct diagnosis was the leading cause of malpractice claims (63.2%), and permanent harm was found in 23.1% of the population. 82.4% of injuries were facial fractures in total population. 65.3% (n = 98) of facial trauma were related with delayed diagnostics (p < 0.001). Permanent harm was more frequent in patients with delayed diagnosis (71.4%) than those without (60.7%, p = 0.299). Claims of craniofacial trauma are related with under-diagnostics, and un-diagnosed facial fracture can lead to a high rate of permanent harm. Systematic clinical evaluation and facial trauma specialist consultation is recommended to set early correct diagnosis for and improve treatment of craniofacial trauma patients.

Impact of facial palsy impact on make-up habits: An observational cohort study

ObjectiveThe esthetic problems inherent to peripheral (PFP) are frequent causes of complaint. Make-up is advocated as a form of therapy and can alleviate symptoms of depression. The aim of the present study was to collect data on make-up habits in female PFP patients and assess links with esthetic and/or functional complaints. Material and methodsTwo questionnaires were drawn up to compare make-up habits in female PFP patients and women in the general population. The first was sent out between September and December 2019, to 39 House-Brackmann grade III PFP patients (group A), and the second on-line questionnaire was sent to a control population of 1385 women (group B). ResultsPFP patients used make-up more often than controls at weekends (χ2=16.38; P=0.0009) and while at home (χ2=8.21; P=0.042), and more often with foundation (χ2=17.21; P=0.0006) and lip make-up (χ2=59.31; P<0.0001). The greater their functional complaint, the less they made up their eyes. The greater their self-confidence and the more they felt attractive, the less they made up their lips. ConclusionThe differences in make-up use found in the present study aimed to mask facial palsy and were related to the esthetic complaint, impacting social life.

Solid Organ Transplant Litigation at One of Europe's Largest University Hospitals.

Due to its intrinsic complexity and the principle of collective solidarity that governs it, solid organ transplantation (SOT) seems to have been spared from the increase in litigation related to medical activity. Litigation relating to solid organ transplantation that took place in the 29 units of the Assistance Publique-Hôpitaux de Paris and was the subject of a judicial decision between 2015 and 2022 was studied. A total of 52 cases of SOT were recorded, all in adults, representing 1.1% of all cases and increasing from 0.71% to 1.5% over 7years. The organs transplanted were 25 kidneys (48%), 19 livers (37%), 5 hearts (9%) and 3 lungs (6%). For kidney transplants, 11 complaints (44%) were related to living donor procedures and 6 to donors. The main causes of complaints were early post-operative complications in 31 cases (60%) and late complications in 13 cases (25%). The verdicts were in favour of the institution in 41 cases (79%). Solid organ transplants are increasingly the subject of litigation. Although the medical institution was not held liable in almost 80% of cases, this study makes a strong case for patients, living donors and their relatives to be better informed about SOT.

Complaint management system and patient satisfaction in grassroots hospitals.

Primary healthcare institutions face limitations in medical resources, leading to concerns from patients and their families regarding the quality of medical services, resulting in complaints against these institutions. This study aims to analyze the causes of complaints and implement improvement measures to enhance the service quality of primary healthcare institutions, increase satisfaction among patients and their families, and reduce the number of complaints. Relevant data were collected, and verified complaints were categorized based on departments, administrative office, and category. Pearson Chi-square test, Spearman correlation analysis, as well as univariate logistic regression were employed to analyze factors influencing patient satisfaction. A complaint-handling process was established, and regulations pertaining to complaints were formulated. Pearson Chi-square test results indicated a significant correlation between satisfaction and departments (P = .016) and administrative office (P = .022). Spearman correlation analysis revealed a significant correlation between satisfaction and departments (ρ = 0.157, P = .017) and administrative office (ρ = 0.151, P = .021). Univariate logistic regression analysis demonstrated a significant correlation between satisfaction and other related complaints in administrative office (OR = 3.321, 95% CI = 1.196-9.218, P = .021). Complaints related to departments and administrative offices are significantly correlated with satisfaction. After the implementation of a complaint management system in primary healthcare institutions, there is a notable improvement in service quality, enhanced patient experience, increased satisfaction, and a reduction in hospital complaints.

Ergonomic analysis applied in aquaculture

Aquaculture plays a very important role in the current Brazilian scenario, helping the income of small families. This activity is considerably new and does not have a specific methodology developed for the fishing activity. Due to these factors, this ergonomic analysis at work (AET) study was carried out, with the purpose of identifying the causes of complaints of body pain and fatigue caused by this activity. For this analysis, the Ergolândia software was used, which is composed of several ergonomic methods. The method used in unloading was the National Institute for Occupational Safety and Health (NIOSH), which deals more specifically with lifting and transporting loads, which analyzes the weight of the load, position of hands and feet, inclination of the trunk, height of the load is raised. Collected data and images were also used as assistance. After carrying out the analyzes and verifying that at all stages the Lifting Index (IL) is above the recommended level, some improvement proposals were made to alleviate or eliminate these employee posture problems. All methodologies identified risk levels that require immediate or short-term ergonomic intervention, aiming to guarantee the safety and health of workers who carry out such activity. The implementation of measures designed to eliminate or minimize risk may involve the allocation of significant human and material resources, increasingly necessary for efficient management. Considering the complexity and variability of the tasks developed, it is recommended that such a decision be preceded by a new study using more precise risk assessment methodologies.

Investigation of Malpractice Claims Concerning Orthopedic Surgeons in Sari, North of Iran, 2015-2020

Introduction: Treatment failure and claims against physicians may have many negative consequences. Orthopedic surgeons have always been among the most used specialists. Therefore, the investigation of causes and the process of these claims can help reduce the negative effects of medical malpractice on physicians and society. Materials and methods: This retrospective study investigated all medical orthopedic negligence cases in Sari, Iran, from March 2015 to March 2020. Data were collected using a researcher-made checklist and analyzed in SPSS software (V-21). Results: Out of 57 finalized cases investigated in this study, surgeons were found liable in 23 (40%) cases. The mean ± SD age of patients was 41 ± 19.3. Moreover, the level of education had a positive correlation with the surgeon’s liability. The most common cause of complaint was reduced Range of motion (ROM) and the most common type of complained surgery was “open reduction &amp; internal fixation” (ORIF). None of the surgeons were found liable due to surgical site infection or device failure. The mean ± SD time for the file processing was 11.1 ± 10.1 months. The mean indemnity payment was 320 million Iranian Rials (9.7% of indemnity for death in Iran). Conclusion: The most effective way to reduce medical complaint cases is to increase the knowledge and skill levels of physicians. The lack of a blinded arbitration system in both organizations could lead to bias in the case assessment process. Moreover, considering the long processing time of the claims, it is recommended that new technologies should be used to reduce the time and increase the accuracy of the final verdict. The absence of a ‘no-fault’ compensation program is a significant flaw in Iran violating patients’ rights. Also, more studies are needed to evaluate justice and equality in Iranian medical commissions.

What’s that noise—Found it! Sometimes

A few case studies involving investigation of mystery noise sources are presented. These address techniques used to identify the cause of complaints, locate noise sources amidst competing noise, and compare predicted sound levels to measured sound levels. The presentation will discuss mysteries solved, our approach to noise control recommendations, and lessons learned. Interesting cases include investigation of a tone generated by an electrical power transmission line pole, office noise control involving malfunctioning HVAC systems, and noise source identification within a quiet multi-family residence.

Why some call the “worst” what most consider the “best”?: an analysis of tourist complaints at the wonders of the world

PurposeThis research explores why tourists are dissatisfied in places considered “wonders of the world”. The authors ask if the place does not match visitors' expectations or if other factors spoil the experience.Design/methodology/approachThe authors analysed the lowest-rated reviews of these wonders on TripAdvisor. The authors identified the main causes of complaints and the problems tourists faced. The authors grouped the complaints into categories and used CoDa.FindingsThe results indicate that dissatisfaction does not stem from unmet expectations regarding the monument itself, but rather from other factors related to the quality of the tourist service.Practical implicationsThe findings of this research can be implemented in those tourist spots that, despite their global popularity, have considerable proportions of unhappy visitors, not due to the attraction itself, but to shortcomings in its administration.Originality/valueThis study provides a deeper insight into the causes of complaints about some of the most renowned monuments, regarded as extraordinary places, where high satisfaction levels would be anticipated. It also contributes theoretically to the literature on customer complaints in tourist places.

Communist Quality: Dairy Production at the Leningrad Dairy Combine, 1965-1982

ABSTRACT Throughout the twentieth century, particularly post-WWII, dairy became a staple part of the “modern” diet throughout many parts of the globe due to new technologies in pasteurization and production. Dairy’s significance was felt in the Soviet Union as well, which used food to improve the standard of living and open another avenue of competition with the West. This study makes two main arguments: Soviet dairy and its ideas of quality were modern in their belief in scientific controls and implementation of new technologies but were distinctly Soviet in that state and scientific actors were the ones to define what was quality in dairy production. While consumer concerns were embraced, they were to be rationalized and filtered through the rational actors in the ministries and enterprises. Using quality reports from the Leningrad Dairy Combine and the Soviet Ministry of Meat and Milk Production, along with articles from professional journals from 1965–1982, this study highlights how Soviet officials had to contend with the Brezhnev era’s focus on consumer abundance while ensuring it remained rational. To reconcile these factors, the Soviet Union sought examples of quality dairy products from foreign countries both in the socialist and capitalist blocs while the Leningrad Dairy Combine tried to address subjective factors of quality like color in “tasting commissions” and address the causes of complaints from the ministry and local shops. However, Soviet consumers were never involved in these processes, setting Soviet dairy, and by extension, Soviet modernity apart from other dairy-rich societies in the West.

#2538 HEALTHY PLANT-BASED DIET IN CHRONIC KIDNEY DISEASE THROUGH USE OF SODIUM ZIRCONIUM CYCLOSILICATE (HELPFUL TRIAL): LABORATORIAL FINDINGS

Abstract Background and Aims Patients with chronic kidney disease (CKD) and hyperkalemia (HK) are counselled to follow a diet restricted in potassium (K) which limits the intake of fruits and vegetables. This is a cause of complaints for many patients. The use of the K lowering medication sodium zirconium cyclosilicate (SZC) has the potential to treat HK and allow a healthy plant-based diet (PBD). We designed a clinical trial to explore the safety and feasibility of prescribing a healthy PBD to CKD patients with HK with the concomitant use of SZC. Method The HELPFUL trial is an ongoing single-arm study with patients with CKD stage 4-5 not on dialysis and with plasma K between 5.1 to 6.5 mmol/L at inclusion. Patients are followed for 6 weeks. In the first 3 weeks, SZC is prescribed to normalize plasma K (pK) while ingesting a low protein diet with low K+ content. In the subsequent 3 weeks, a healthy PBD with a target K intake of 3700 mg/day is prescribed maintaining the use of SZC. A food basked with the PBD is delivered to the participants weekly. A weekly monitoring of pK and titration of SZC to keep normokalemia is performed. Other laboratorial measurements and food intake are assessed at baseline, week 3 and week 6. Food intake is evaluated using the 24-hour food record (24HFR). Data was analyzed by repeated measures-ANOVA or by Friedman test for related samples, as appropriate. The protocol is registered at www.clinicaltrials.gov (identifier NCT04207203). Results 22 patients were included (59±13 years; 13 men, 59%). Table 1 describes the main findings. During the study, eGFR did not change, serum urea decreased, and P-carbon dioxide increased significantly. Inflammatory markers, 24hour urinary sodium and K excretion did not change. Potassium intake from 24h-FR increased, as well as the intake of fruits, vegetables and nuts after the PBD. The mean pK normalized in week 3 and 6. After the start of PBD, 3 patients (13.6%) had pK between 5.1 and 5.3 mmol/L. Most patients needed SZC dose of 10g/day. No changes were observed in dose of RAAS. Conclusion The strategy of PBD food basket with concomitant use of SZC allowed an increase in dietary K intake with higher intake of fruits, vegetables and nuts. P-carbon dioxide, a surrogate of bicarbonate improved as well. The pK was kept withing normal values for most of the patients.

One-to-one marketing management via customer complaint

For companies to retain customers and ensure effective management-level resolution, they need to anticipate customer churn and determine the root cause of complaints. To achieve this, analyzing personalized complaints from the customer's perspective is crucial. This research advocates for a multidisciplinary approach that combines language behavior, relevance feature extraction, feature weighting, and sentiment analysis to extract the underlying problem in real-time. Applying this approach to the CFPB database sample yielded an accuracy rate of 82% and a system validity of 75%, which can help improve customer service and protect consumers in the financial and other service industries. By addressing individual customer issues that cause dissatisfaction, businesses can enhance customer satisfaction and retention levels. Thus, by analyzing complaints from a personalized standpoint, companies can identify the root cause of the problem, improve their services, and establish stronger customer relationships.

Impartiality and fair play revisited

Impartiality and fair play revisited

Epidemiology of the causes of complaints after discectomy collected from a French insurance company

IntroductionLumbar discectomy is a frequent procedure performed by surgeons from specialties at risk of patient complaints. The objective of the study was to analyze the causes of litigations following lumbar discectomy to be able to reduce their frequency. Material and methodsThis observational, retrospective study was carried out at a French insurance company (Branchet). All files opened between the 1st of January 2003 and the 31st of December 2020, following lumbar discectomy without instrumentation and without any other associated code, undertaken by a surgeon insured by Branchet, were analyzed. The data was extracted from the database by a consultant from the insurance company and analyzed by an orthopedic surgeon. ResultsOne hundred and forty-four records met all inclusion criteria and were complete and available for analysis. Infection was the leading cause of litigation, responsible for 27% of complaints. Residual postoperative pain was the second cause of complaint with 26% of cases, of which 93% had persistent pain. Neurological deficits were the third cause of complaint with 25% of cases among which 76% were related to the appearance of a deficit and 20% related to the persistence of an existing deficit. Early recurrence of herniated disc also appeared as a cause of complaint, accounting for 7% of cases. ConclusionSurgical site infection, persistence of pain, and the appearance or persistence of neurological disorders are the primary causes of complaints leading to investigation in the aftermath of lumbar discectomy. It seems essential to us that this information be brought to the attention of surgeons to enable them to better adapt their explanations in the delivery of preoperative information. Level of evidenceIV.

Analysis of Testing and Measuring the Work Environment against Air Microorganisms in PT. PLN (Persero) UPK Nagan Raya

Working environment conditions that do not meet the requirements can cause health problems in workers. Air quality, temperature, radiation, ventilation, lighting, and various chemicals in the building are very important causes of complaints and symptoms of microorganisms. This study aims to determine the air microorganisms in the K3 room of PT. PLN UPK Nagan Raya and analyze the air for microorganisms in the K3, WTP, and environmental rooms. Based on the study's results, the multiple linear regression test (simultaneously) obtained a p-value of 0.656, a p-value value &gt; 0.05. It can be concluded that all independents significantly affect dependent variables. The partial test results showed significant values, namely 0.699 and 0.656, and the test results of the multiple linear regression equations obtained values Y = -1702,500 X1 + 20,650X2.

COMPLIANCE WITH THE PRINCIPLE OF EQUAL TREATMENT IN PUBLIC PROCUREMENTS

On 1 March 2007, the new Public Procurement Law entered into force, which aims to ensure free competition of economic operators, as well as equal and fair treatment thereof. However, the practice of Procurement Monitoring Bureau shows that one of the most common causes of complaints made to Procurement Monitoring Bureau is non-compliance with the principle of equal treatment by contracting authority both in the wording of tender regulations, namely, by inclusion of non-equal requirements in relation to different categories of tenderers, and in the assessment process of the tenders of the tenderers. This imposes unjustified restrictions on competition and serves as a basis for corruption.

Postoperative analgesia in children - a comprehensive assessment and management

Introduction. Pain is the most common cause of complaints in hospitalized pediatric patients. Pain continues to be underestimated and undertreated in childhood. The European Society of Pediatric Anesthetists has published guidelines for pain management in children. Pain assessment. Pain assessment is very important in the treatment of pain in children. Basic pain management. Administration of basic analgesics is crucial for pain management. Paracetamol and non-steroidal anti-inflammatory drugs. Generally, basic or simple analgesia includes the use of paracetamol and non-steroidal anti-inflammatory drugs. Systemic opioids. Opioids are reserved for early postoperative and intraoperative use when adequate monitoring and specially trained personnel are available around the clock. Regional anesthesia and local anesthetics. Regional anesthesia in children has been increasingly used in recent decades, particularly against the background of multimodal analgesia. Conclusion. Basic analgesics are crucial, and opioids are added only when needed. Regional anesthesia and local anesthetics play a superior role in pain management compared to systemic analgesics in such cases in pediatric patients.

Combined Protocol of Micro Needling with Chemical Peelings for Intimate Skin Whitening

Post-inflammatory hyperpigmentation in the intimate region is a cause of complaint among women with skin phototypes II and IV. Several techniques such as Laser, chemical peelings, skin lighteners are used in isolation without success in the treatment of these dyschromia. The present study shows a practical and systematic way of combining micro needling techniques, chemical peelings and home care depigmenting agents, with just one treatment session, promoting significant lightening of hyperchromia in women.

Indoor air quality and early detection of mould growth in residential buildings: a case study.

Mould growth affects one in three homes, and it is the biggest cause for complaints and litigations filed to the relevant authorities in Australia, while also significantly affecting the physical and psychological health of the building's occupants. Indoor mould is caused by excessive dampness, resulting from poor architectural specification, construction and maintenance practices, as well as inappropriate behaviour of the occupants. The consequences range from early biodeterioration of building materials, requiring anticipated renovation works, to deterioration of the indoor environment, posing a serious threat to the building's occupants. This study investigates indoor air quality (IAQ) and mould growth, providing a snapshot of the current IAQ of Australian residential buildings regarding air pollutants. It uses a case study representative of the typical Australian suburban home to investigate the effects of unnoticed mould growth. The results of the monitoring campaign indicate that buildings with a high concentration of fungal spores are also more likely to present poor IAQ levels, high concentrations of particulate matters (PM10 and PM2.5) and carbon dioxide (CO2). This research suggests the need for the development of early detection strategies that could minimise the health hazard to people, thereby preventing the need for any major renovations.

Clinical and genetic characteristics of Chinese Duchenne/Becker muscular dystrophy patients with small mutations.

Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are amongst the inherited neuromuscular diseases with the highest incidence. Small mutations are less common and therefore have been poorly studied in China. The clinical data of 150 patients diagnosed with DMD/BMD by genetic analysis in Hunan Children's Hospital from 2009 to 2021 were analyzed. The patients were followed up for an average of 3.42 years and their clinical characteristics were collected. Loss of ambulation (LOA) was used to evaluate the severity of disease progression. The correlation among clinical features, different variants, and glucocorticoid (GC) treatment was analyzed by Cox regression analysis. 150 different variants were detected in this study, including 21 (14%) novel mutations, 88 (58.7%) non-sense mutations, 33 (22.0%) frameshift mutations, 22 (14.7%) splicing mutations, and 7 (4.7%) missense mutations. Single-exon skipping and single- or double-exon (double/single-exon) skipping strategies covered more than 90% of patients with small mutations. A case with frameshift mutation combined with Klinefelter's syndrome (47, XXY) and another one with missense mutation combined with epilepsy was found in our study. De novo mutations accounted for 30.0% of all patients. The mean onset age was 4.19 ± 1.63 years old, and the mean diagnosed age was 5.60 ± 3.13 years old. The mean age of LOA was 10.4 years old (40 cases). 60.7% of them received GC treatment at 7.0 ± 2.7 years old. The main causes of complaints were muscle weakness, high creatine kinase (CK), motor retardation, and family history. The risk factors of LOA were positive family history (HR 5.52, CI 1.26-24.18), short GC treatment duration (HR 0.54, CI 0.36-0.82) and frameshift mutation (HR 14.58, CI 1.74-121.76). DMD patients who treated with GC after 7 years old had a higher risk of earlier LOA compared to those receiving treatment before the age of 7 (HR 0.083, CI 0.009-0.804). Moreover, an earlier onset age, a higher CK value, and a larger LOA population were found in the DMD patients compared to the BMD ones. Finally, the locations of the most frequent mutation were in exon 70 and exon 22. In conclusion, 150 small mutations were identified in this study, and 21 of them were discovered for the first time. We found the hotspots of small mutations were in exon 70 and exon 20. Also, the analysis showed that positive family history, frameshift mutation, short duration of GC treatment, and delayed GC treatment resulted in earlier LOA for the DMD patients. Taken together, our findings complement the mutation spectrum of DMD/BMD, benefit us understanding to the DMD disease, and lay foundations for the clinical trials.

Monkeypox and Psychotic Manifestations: Possible But Little Recognized Clinical Manifestations

The pox virus is an important pathogen that can cause disease in humans. Monkeypox is a unique type of pox infection. The WHO has acknowledged the seriousness of a massive monkeypox outbreak in 2022. The disease usually presents as an acute febrile illness with skin lesions. The patient usually has many painful vesicular lesions, and this is a common cause of complaint for patients visiting the physician. The patient usually has a history of contact with an infected case and gets the disease. However, sometimes fever or skin damage cannot be detected. Without the special appearance, doctors may miss the problem and make the wrong diagnosis. Basically, clinical diagnosis is the simplest procedure and must be used by practitioners. Laboratory methods can help confirm the diagnosis. The gold standard for diagnosis is molecular-based diagnosis. However, it is important to recognize the atypical clinical problems of monkeypox. In this article, the authors discuss the psychiatric manifestations of monkeypox, a clinical issue that is somewhat addressed. In brief, mental problems are possible in monkeypox. The mental disorder might be the first clinical presentation. In rare cases, patients might have confusion and it is difficult to diagnose. Awareness of the problem is needed. Additionally, the stigma is an important problem for patients with monkeypox. Some patients might have suicidal attempts. Therefore, it is necessary to have good mental health monitoring and support for patients with monkeypox. Last, similar to the previous COVID-19 situation, the influx of new data on monkeypox has occurred and it might be the cause of panic for general people. It is necessary to prepare for control of fake news and provide mental health support to the general public during the outbreak of monkeypox.