Source Of Complaints Research Articles

Acoustic measurements of wind farm noise inside homes and comparison with the ISO 9613 standard

To achieve the energy transition objectives, many wind farms are installed to produce electricity by exploiting wind energy. The production of electricity through wind farms is widespread in the world. One of the problems complained about by people who live near wind farms is the noise emitted by the rotation of the blades. This work reports acoustic measurements inside homes near wind farms. The acoustic measurements were performed for different wind speeds and directions. Furthermore, to verify the effectiveness of the simulation method of the propagation of the noise generated by wind farms, the measured values of the sound levels were compared with those obtained from the numerical simulations using the provisions of the ISO 9613 standard, and the wind turbines are considered point-like sound sources. The comparison between the measurements carried out in the field with the theoretical simulations has highlighted that the calculated levels are lower than the measured ones, this means that in the acoustic impact forecasting procedures, the noise emitted by the wind farms is underestimated and is one of the reasons why the Wind farms in operation are a source of complaints from the populations living nearby.

Study on vibration measurement and sensory evaluation of combined vibration for detached houses

Sensory and psychological content accounts for 90% of all vibration complaints in Japan. Therefore, evaluation based on vibration sensation is very important. Traffic vibration is the most common source of vibration that causes complaints, when limited to detached houses. If traffic vibration is the source of complaints, occupants will suffer from vibration for a long period of time. Vibration transmitted by traffic to housing floors may not be either vertical or horizontal, but rather a combination of both vertical and horizontal vibration that exceed perceptual thresholds. Japanese standards include "JIS C 1510" and "AIJES-V0001-2018". However, they do not describe methods for sensory evaluation of combined vibration. Although ISO 2631 series describes it, it is necessary to consider whether it can be applied to Japan as it is. Considering that traffic networks will continue to develop in Japan, especially in urban areas, it is assumed that the vibration generated inside houses, mainly from traffic vibration sources, will not be a single vibration of vertical or horizontal vibration, but a combined vibration that is perceived in multiple directions. Therefore, in this paper, vibration measurement and sensory evaluation of combined vibration were examined using a real house vibrated by traffic.

CLIENT SATISFACTION AND WAITING TIME IN MCH EMERGENCY

The emergency departments are often a source of complaints. Due to the COVID-19 pandemic, we are facing an increase in the number of patients in MCH ER. The patients are referred from all over the country, which increases the burden on the facility compared to the available resources. The department has to face the burden of non-booked patients secondary to the COVID-19 pandemic presenting to the MCH ER, leading to increased complaints about client dissatisfaction regarding the Emergency department. Hence, we decided to audit our current ER and plan interventions to improve our practices. We propose to formulate recommendations for other facilities facing similar challenges. This study aimed to determine the waiting time and total length of stay in the mother and child health care emergency of the Pakistan Institute of Medical Sciences to plan interventions to reduce client dissatisfaction. An audit study was conducted from 1st September 2021 to 30th September 2021, and then a re-audit with interventions was carried out from 1st April 2022 to 30th April 2022 at the Emergency of Mother and Child Health and Care Center of Pakistan Institute of Medical Sciences. The Study had the active participation of duty doctors, nurses, paramedics, statisticians, computer operators, personnel from HMIS, workers, and patients. This study was conducted to determine our practices in an emergency. The data was collected from maintained existing paper-based doctors' and staff nurses’ registers. The duty doctor manually enlisted patient’s data on worksheets, this data was then shared in the "MCH ER WhatsApp group" and compiled. The data was entered on SPSS 25 and analyzed. Primary Outcome measures were waiting time for assessment, primary (registration to triage time), secondary assessment (triage to decision time), and total length of stay in ER (Door to deposition time). Secondary outcome measures included client dissatisfaction rate. A total of 1447 patients were included, of which 46 % were from Islamabad and 38% were from Rawalpindi. The first assessment by a duty ER doctor within 5 minutes (registration to triage time) was 16.4%, which increased to 25.5%, and 59.2% at 30 minutes, which increased to 70.7% in the re-audit. The second assessment by senior (doctor to decision time) within 30 minutes was 59% and increased to 69% in re-audit. Admissions were offered to 33.6%, 1.1% left against medical advice (LAMA), and 38 % were lost to follow-up. The total length of stay in MCH ER (Door to deposition time) was 3 hours mean (195 min) in 60% of the patients (37.9% of patients were admitted, 22.1% were discharged). In the re-audit, 69.6% were admitted after interventions, 27.6% were discharged (97% door to deposition time within 3 hours with a (mean time of 180 min ), 1.8% LAMA and only 1% were lost to follow-up. Both study cycles had no significant change in CTGs, ultrasounds, or baseline investigation frequency. Complaints can be curtailed by taking measures such as adding another duty doctor in emergency for immediate triage, early second assessment by seniors to shorten the triage to decision time, and avoiding unnecessary ultrasounds and baseline investigations. The most significant determinant of client satisfaction in the ER is the short length of Stay in the ER that is, arrival to deposition time.

Malpractice litigation after total hip arthroplasty: A legal 10-year database.

In this study, we aimed to identify the most frequently reported claims after total hip arthroplasty (THA) and the reasons put forward by the plaintiffs. Between January 2011 and December 2020, data of a total of 74 cases (21 males, 53 females; mean age: 53.7±12.8 years; range, 29 to 83 years) obtained from the Turkish Forensic Medicine Institute were retrospectively analyzed. Claims for litigation, demographic data, data regarding the identity of the accused and the hospital setting were recorded. The most common reason for lawsuits was death (n=15; 20.3%), followed by nerve injury (n=13; 17.6%), and eight patients had more than one complaint. According to the forensic medicine reports, malpractice was detected in 10 (12.5%) of the cases. Among the hospital types, only nerve injury made a significant difference among all complaint sources in different hospital settings (p=0.003). In our study, death was the most common reason for lawsuits regarding malpractice accusations after THA, which is different from medical malpractice allegations throughout the world.

Evolution of awareness for cognitive decline across several cognitive domains in stable vs clinically progressing participants.

AbstractBackgroundAwareness of memory impairment has been shown to vary across the AD spectrum with an initial heightened awareness at the preclinical stage, and a subsequent loss of awareness with AD progression (Hanseeuw et al.,2020). Whether there are potential differences in the evolution of awareness for cognitive domains other than memory is unknown. In this study, we investigated the evolution of awareness in visuospatial, language, planning, divided attention and organization in cognitively older adults that later progressed versus those who remained stable.MethodsOur study included 621 cognitively normal (CN) ADNI participants (Tab1). Individuals were considered Stable or Progressors (n = 147) on the basis on the Clinical Dementia Rating scale global score (stable: scores at first and last observation both 0, progression:last score≥0.5). Cognitive complaints were recorded using the Everyday Cognition (ECog) questionnaire, using both participant’s and informant’s average complaints in each of the six subscales: divided attention, language, memory, organization, planning and visuo‐spatial. Generalized linear mixed‐effect models were run to predict complaints within each subscale, using time, the source of complaint (informant vs participant), and their interaction as independent variables, adjusting for age, gender and education. Jonhson‐Neyman Points (JNP) were computed for significant interactions, and simple slopes analyses were performed.ResultsStable participants displayed a similar evolution of both informant and participant complaints (Fig1, left panels). Among progressors, all models showed significant interactions with participants expressing greater, and subsequent lower complaints than informants (Fig1, right panels). JNP analyses revealed that, while on some subscales this transition occurred only after/close to progression (i.e., divided attention, language, memory and organization), it could be observed years before progression in others (i.e., planning and visuo‐spatial).ConclusionsProgressive participants expressed greater, and then lower complaints as compared to their informant, demonstrating a transition from heightened to reduced awareness over time. Our results attest that, while most studies are focusing on memory awareness, other domains might also show early changes in awareness. This advocates for including the informant’s appraisal in the examination process, as well as to expand the focus to other cognitive abilities.

Domain‐specific self‐ and informant‐reported cognitive complaints across the Alzheimer’s disease spectrum

AbstractBackgroundA growing number of studies are currently investigating whether Subjective Cognitive Decline (SCD) may represent an early indicator of Alzheimer’s disease (AD). Due to the high frequency of amnestic AD dementia, SCD research is highly focused on episodic memory. Non‐amnestic complaints are less studied, although patients or their families often report difficulties in retrieving words, planning or spatial orientation, to name a few (e.g., Valech et al., 2018, J Alzheimers Dis). Furthermore, few studies have investigated which source of complaint is the most accurate. In this study, we aimed to measure how accurately self‐ and informant‐reported complaints in different cognitive domains can discriminate individuals along the AD continuum and controls.MethodWe selected four groups of participants from the ADNI cohort: amyloid‐positive (Aβ+) individuals with AD, mild cognitive impairment (MCI) or cognitively normal (CN), and amyloid‐negative (Aβ‐) CN controls. Self‐ and informant‐reported complaints were measured with the Everyday Cognition questionnaire in four domains, namely, memory, language, visuospatial abilities, and executive functions. Receiver operating characteristic curves analysis was performed to evaluate the accuracy of the ECog scores in discriminating the groups.ResultSelf‐ and informant‐reported complaints were distributed as follows: memory, language, executive, and visuospatial (from the most severe to the least severe). ECog‐Subject scores globally distinguished groups little better than chance. The Memory score performed best among the ECog‐Subject scores, but the accuracy was low to moderate. In the other three domains, most AUCs were below 0.70 and specificities always below 70%. All ECog‐StudyPartner scores (i.e., in all four cognitive domains) could discriminate MCI and AD from CN, as well as AD from MCI, with good to excellent accuracy (all AUCs between 0.72 and 0.98). However, no ECog‐StudyPartner score seemed useful in distinguishing Aβ+/CN and Aβ‐/CN subjects (all AUC<0.55, all specificity indices <0.22).ConclusionSelf‐reported SCD may have limited utility for both early diagnosis and the inclusion of subjects in research protocols. Individuals with early‐stage AD may already present reduced awareness of their cognitive decline (e.g., Cacciamani et al., 2021, Alzheimer’s Res. Ther). For this reason, it seems crucial to consider informant‐reported complaints, both amnestic and non‐amnestic.

662 ENHANCING CARE BY IMPROVING DISCHARGE SUMMARIES

Abstract Introduction Within the Geriatric Medicine department at the Lister Hospital, Stevenage, the timeliness and quality of discharge summaries had become a source of complaints. Both primary care practitioners and families reported documentation was inadequate or incorrect. This project aimed to improve the quality of these discharge summaries in accordance with standards generated from previous audit data. Through improving communication it was clear that patient care could be enhanced. Methods Each month 15 discharge summaries were selected at random for review. Alongside patient notes these summaries were appraised in regards to standard discharge summary requirements: timeliness of delivery; adequate description of admission; and documentation of the follow up plan. They were also appraised on documentation of specific requirements for older aged adults including cognitive status, mobility status, discharge destination, need for home help, Rockwood Frailty score and resuscitation and escalation plans. Interventions including informal communication with junior doctors, circulation of a ‘Top Tips’ sheet, generation of an information poster and dissemination of information at local teaching sessions, took place, and were assessed, over regular PDSA cycles. Results showed a clear, sustained improvement in the quality of the discharge summaries. At the end of data collection, 100% of discharge summaries contained an adequate description of admission and an appropriate follow up plan. There was also significant improvement in documentation of specific requirements. Where documentation was initially very limited, following interventions, most discharge summaries contained details pertaining to discharge destination, need for home support, mobility status and resuscitation and escalation plans. Conclusion The relatively simple interventions have been found to have a sustained improvement in the quality of discharge summaries from the Geriatric Medicine Department at Lister Hospital, Stevenage. Whilst more work needs to be done it is hoped that this will already have enhanced patient care.

Gait characteristics during crossing over obstacle in patients with glaucoma using insole foot pressure.

Background:Glaucoma, is the most common cause of irreversible visual deficits, presents as an injury to the optic nerve and it is mainly associated with elevated intraocular pressure. The main symptom of glaucoma is a reduction of the visual field, which is usually a source of complaint at the advanced stage of disease. Because of visual deficit, gait dysfunctions, including low gait speed and increased bumping into objects, postural sway, and falling are occurred. Many studies have used stopwatch or motion-sensing devices to report on gait function following glaucoma. However, there are few reports on gait dysfunction assessed by examining foot pressure. This study investigated gait ability following glaucoma according to different gait conditions by assessing foot pressure.Methods:Thirty older adults (15 in the sex- and age-matched normal group and 15 in the glaucoma group) were recruited for this study. All participants were walked under 2 different gait conditions in an F-scan system and the subject’ assessments were randomly assigned to rule out the order effect. Conditions included: gait over an obstacle in a straight 6 m path, gait in a straight path without an obstacle in the 6 m path. Gait variables included cadence, gait cycle, stance time, center of force (COF) deviation, and COF excursion. About 10 minutes were taken for gait evaluation.Results:When walking without an obstacle on a 6 m path, there were significant differences between the 2 groups in gait speed, cadence, gait cycle, and stance time (P < .05). There were significant differences when walking with an obstacle on a 6 m path (P < .05). Two-way analysis of variance showed significant effects associated with “glaucoma” not gait condition on all outcomes except for COF deviation and excursion. Also, there was no the interaction effect between “glaucoma” and “gait condition.”Conclusion:We demonstrated that glaucoma patients selected the gait strategy such as lower gait function in both gait conditions particularly, slower gait speed and cadence and longer gait cycle and stance time, as determined by examining foot pressure. We believe that our results could help to improve the quality of life of patients with glaucoma.

Using the Model for Improvement and Plan-Do-Study-Act to effect SMART change and advance quality.

Using the Model for Improvement and Plan-Do-Study-Act to effect SMART change and advance quality.

Normal Variations and Pathologic Disorders of Chondrification and Ossification of the Foot and Related Diseases.

Formation of the skeletal elements of the foot involves different stages of development. Failure in segmentation of the cartilaginous plate is supposed to be the underlying mechanism leading to tarsal coalition. Variants or disorders in ossification might result in harmless osseous anomalies or symptomatic disease. When the ossification is almost completed, several secondary ossification centers start to ossify. They are usually incidental findings. In symptomatic patients they have to be differentiated from fractures or can be the source of complaints by themselves.

Influence of Environmental Factors on the Production of MIB and Geosmin Metabolites by Bacteria in a Eutrophic Reservoir

AbstractOccurrences of odorous bacterial metabolites, 2‐methylisoborneol (MIB) and geosmin (GSM), in drinking water supply reservoirs are considered as a nuisance by the water industry and a source of complaints from customers. In Eagle Creek Reservoir, routine monitoring programs of MIB and GSM highlight intense odorous outbreaks during the spring season when high inflow discharges occur. Cyanobacteria have always been assumed to be source of these metabolites even if no known producers are present in raw water. A copper‐based algaecide is often used to terminate the metabolite production and the algal growth in the reservoir. The current study was designed to investigate and identify other biological sources involved in the biosynthesis of MIB and GSM metabolites as well as environmental factors that could be important triggers for the growth of bacterial producers. The community structure of the bacterioplankton was determined using a 16S rRNA gene sequencing technique, which showed that not only Cyanobacteria but Actinobacteria also were involved in the reservoir internal production. Planktothrix species was identified as the main source of GSM (p &lt; 0.001) while Streptomyces (Actinobacteria) was very likely responsible of MIB (p &lt; 0.01). Application of an algaecide disrupted GSM and the growth of Planktothrix but was less effective against MIB and Streptomyces. Statistical analyses revealed that MIB‐ and GSM‐causing bacteria were found abundant when the water was enriched with nitrogen, temperature cooler, and the water column mixed.

The Role of Ehrs in Rapid Response Call Outs: A Case Study

This study aimed to determine the source of complaints about the poor usability and lack of fit between rapid response documentation screens and rapid response (RR) processes. A modified Contextual Design research approach was implemented to explore RR processes and the congruence between these and RR documentation screens. Participants were 15 consenting clinicians from an orthopaedic ward, a rapid response team and an Intensive Care Unit. Results show that RR team documentation screens do not support clinical work that is integrated, iterative and ongoing. The relaxation of conceptual and EHR technological constraints may facilitate more effective support for clinical work.

Complaints about chiropractors, osteopaths, and physiotherapists: a retrospective cohort study of health, performance, and conduct concerns

BackgroundRecent media reports have highlighted the risks to patients that may occur when practitioners in the chiropractic, osteopathy and physiotherapy professions provide services in an unethical or unsafe manner. Yet research on complaints about chiropractors, osteopaths, and physiotherapists is limited. Our aim was to understand differences in the frequency and nature of formal complaints about practitioners in these professions in order to inform improvements in professional regulation and education.MethodsThis retrospective cohort study analysed all formal complaints about all registered chiropractors, osteopaths, and physiotherapists in Australia lodged with health regulators between 2011 and 2016. Based on initial assessments by regulators, complaints were classified into 11 complaint issues across three domains: performance, professional conduct, and health. Differences in complaint rate were assessed using incidence rate ratios. A multivariate negative binomial regression model was used to identify predictors of complaints among practitioners in these professions.ResultsPatients and their relatives were the most common source of complaints about chiropractors, osteopaths and physiotherapists. Concerns about professional conduct accounted for more than half of the complaints about practitioners in these three professions. Regulatory outcome of complaints differed by profession. Male practitioners, those who were older than 65 years, and those who practised in metropolitan areas were at higher risk of complaint. The overall rate of complaints was higher for chiropractors than osteopaths and physiotherapists (29 vs. 10 vs. 5 complaints per 1000 practice years respectively, p < 0.001). Among chiropractors, 1% of practitioners received more than one complaint – they accounted for 36% of the complaints within their profession.ConclusionsOur study demonstrates differences in the frequency of complaints by source, issue and outcome across the chiropractic, osteopathic and physiotherapy professions. Independent of profession, male sex and older age were significant risk factors for complaint in these professions. Chiropractors were at higher risk of being the subject of a complaint to their practitioner board compared with osteopaths and physiotherapists. These findings may assist regulatory boards, professional associations and universities in developing programs that avert patient dissatisfaction and harm and reduce the burden of complaints on practitioners.

Concealing a shiny facial skin appearance by an Aerogel-based formula. In vitro and invivo studies.

To explore, invitro and invivo, the potential interest of an Aerogel-based formula, in concealing a naturally shiny facial skin. In vitro, various formulae and ingredients were applied as a thin film onto contrast plates and studied through measuring the shine induced following pump spraying of a mixture of oleic acid and mineral water as a sebum/sweat mix model. In such a test, an Aerogel ingredient led to very positive results. In vivo, two different formulae with various concentrations of Aerogel were randomly tested on half side of the face vs. bare side of Chinese women, under some provocative environmental conditions, known to enhance facial shine. These conditions comprised a normal activity under a hot and highly humid summer time followed - or not - by a hamam session. Both studies included comparative evaluations using a half-face procedure (treated/untreated or vehicle). In the first case, evaluations were quantitatively carried out, whereas the second one was based on a quantitative self-evaluations from standardized full-face photographs RESULTS: In vitro, the tested Aerogel, incorporated at 1% or 2% concentration in a common O/W cosmetic emulsion, shows an immediate light scattering effect, thereby masking shine. Such effect appears of much higher amplitude than that of two other tested particulate ingredients (Talc and Perlite). A noticeable remanence of anti-shine effect was confirmed invivo in extreme conditions. The latter was self-perceived by all participants in the second study. This result is likely related to the super hydrophobic behaviour of the Aerogel. As cosmetic ingredient, this new Aerogel appears as a highly promising ingredient for concealing the facial skin shine, a source of complaint from many consumers living in hot and humid regions.

Las querellas de la paz: patronato real, público y liturgia en la Nueva España, 1750-1800

In the 16th century, the Catholic Reformation abolished the kiss of peace among the faithful in the ceremonies of the Mass, establishing instead the Pax-board at solemn Masses, reserved for clergy, sovereign, and magistrates. In the Hispanic world, particularly in the realm of New Spain during the second half of the eighteenth century, Pax became a source of complaints among the clergy, judges, and members of local councils. While bishops and clergy were trying to preserve what they considered a separate and distinctive element of sacred ceremonies and distinctive characteristic of the clerical hierarchy, the civil authorities claimed its presentation based on Patronage on the Church, as well as reasons for public utility.

Challenges and design of a data-oriented complaint and failure management

Companies have to address several crucial issues to remain competitive in a fast developing, digitalised and connected world. Due to connected machinery and new sources of complaint and failure data the amount of acquired information is constantly increasing. Furthermore customer requirements experienced a strong tendency to individualised products which led to an increased data complexity. To process this kind of information and prepare it for sustainable improvements in production and product developments a data-driven design of an intelligent complaint and failure management (CFM) is inevitable. This paper builds up on existing approaches for CFM and outlines the global challenges which have to be addressed in terms of a continues improvement process. Therefore a data-driven reference process is introduced. Furthermore an integration of this process requires different enablers (e.g. IT infrastructure, failure coding, key performance indicator sets, etc.). To emphasise how the outlined challenges can be addressed in practice several concrete examples are sketched out. The central findings of this paper are a data-driven reference process for CFM just as the determination of the necessary tools and infrastructure. It exceeds the state-of-the-art process designs in terms of data orientation, the outlined enablers as the necessary supporting background.

Control de la obra terminada: inspección final de calidad en un proyecto de interés social

Social housing is often associated to buildings of low quality level; however it is important to have objective elements to verify this question so the control of thefinished work constitutes a good quality measure. This study presents and evaluates the problems found in a typical social housing project funded under the Brazilianhousing program Minha Casa, Minha Vida, built in Sao Leopoldo, a city on southern Brazil. The work was monitored during the last six months of its final phase ofexecution. The inspection reports of the completed work were analyzed and observations were proposed directly at the construction site. The first owner’s inspectionreached about 64% failure. In some cases, it took four attempts to finally obtain the owner’s acceptance. Analyzing data collected we concluded that windows,doors and ceramic coverings were a major source of complaints, reaching more than 77% of the problems pointed out in the inspections. The failures detected in thisproject were caused by problems related to workmanship, lack of quality of materials and the components used, as well as insufficient quality checks of the servicesperformed. We observed the need to improve quality controls although the building firm had a certification by PBQP-H (a Brazilian certify similar to the ISO 9000).The correct procedures were defined on quality documentation but they were not followed. Rev. ing. constr. [online]. 2015, vol.30, n.2, pp. 147-153. ISSN 0718-5073. http://dx.doi.org/10.4067/S0718-50732015000200006

A survey on characteristics of leachate pond in an offshore municipal solid waste disposal site

Leachate from a landfill is collected and flowed in leachate accumulation pond, and sent to treatment facility. However, leachate in the pond can be a source of complaints from residents due to off coloration or odor, particularly near heavily populated urban areas. In this study, for the purpose of appropriate control of leachate pond, pond water and sediment were sampled in an offshore municipal solid waste disposal site 2 years after the disposal site was closed, and analyzed some parameters to estimate their properties. The pond water had high alkalinity due to the disposal of incineration residues, and EC and CODMn were also high. On the other hand, Cr, Mn, Fe, Cu, Zn, Cd, and Pb did not exceed the Japanese effluent water standards. Total sulfide was detected from all sediment samples during the sampling period, and values in the summer were slightly higher than at other times. To investigate the stabilization of targeted disposal site, the relationships among cumulative liquid/solid ratio (L/S) with pH and Cl− elution after closing the site were examined. Both parameters showed a direct relationship with cumulative L/S ratio, which can be anticipated to continue increasing in the future.

Office floor vibrations: evaluation and assessment

Excessive levels of vibration in office floors have become a common source of complaint by occupants and building owners in recent years. The need for large open-space working areas, the availability of light and high-strength building materials, the use of computer-aided design and lighter building contents due to paperless offices are the main factors causing the problem. The evaluation and assessment of floor vibrations as related to human perception and comfort are therefore important issues to consider. Several standards and design guides include provisions to address these requirements. The most recent research studies and standards recommend the use of vibration dose value (VDV) for such evaluation, which is believed to provide a consistent and reliable measure of vibration acceptability to humans. Using the results of tests conducted on four different building floors, this paper studies the provisions of the recent standards for the estimated vibration dose value (eVDV) and attempts to clarify their applications. It is found that a vibration duration based on a peak absolute frequency-weighted acceleration of more than 0·015 m/s2 provides consistent evaluations in terms of human reaction to vibration. This paper also compares the provisions of various standards and design guides in terms of building floor vibration acceptability levels. It is concluded that the use of VDV results in a more consistent and less conservative outcome than other criteria such as peak absolute acceleration.

Endoscopic Correction of Inferior Implant Malposition in Augmented Breasts with Electrocauterization

Breast augmentation surgery has been the most popular cosmetic surgery in the United States since 2006, accounting for 290,000 cases in 2013 [1]. Unfortunately, complications from the procedure can result in a reoperation rate approaching 15.5%. Complications after breast augmentation include capsular contracture, size change, malposition, waviness, deflation, infection, ruptured gel, palpability, and anxiety [2]. ‘Bottoming out’ is the term that describes an increase of the distance between the nipple areolar complex and the inframammary fold. In augmented breasts, inferior displacement of the breast implant beyond the inframammary fold can also be a causative factor. There are numerous procedures for correcting bottoming out, such as single or multilayer capsulorrhaphy, with or without mirror-image selective capsulotomy [3,4], capsulopexy [5], capsular flaps [6], polypropylene mesh, cadaveric dermis, and intracapsular allogenic dermal grafts [7-9]. However, these methods have drawbacks of larger incisions, longer surgical time, and possibility of infection caused by allogenic materials. Longer surgical time and costly allogenic materials can be sources of complaints and a burden for both the surgeon and the patient. In this case report, we propose a simple procedure for correcting an inferiorly malpositioned implant via an endoscopic approach.