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Abstract Background Most studies on injuries of professional dancers used a medical-attention and/or time-loss definition and did not analyse all health problems. Further, almost all studies included just one company. The aim was to analyse all self-reported health problems of professional ballet and contemporary dancers during one season and compare sexes and five companies in Germany. Methods Dancers of five professional companies completed weekly health questionnaires during the season (September 2022 to June 2023). Numerical rating scales were used for severity of all health problems, musculoskeletal pain, impairment of the ability to dance at full potential, physical and mental workload in the previous seven days. If the severity of all health problems were rated greater than “0”, the dancers were asked to report the type and consequences of their most severe health problem. Results During 43 weeks, 98 dancers (39.8% male) completed 3123 weekly reports (response rate 74.1%). The season prevalence of any health problem was 100% and of time-loss health problems 74.5%. The average weekly prevalence of any health problem was 62.7%, of musculoskeletal pain 83.4% and of impaired ability to dance at full potential, due to health problem 48.6%. While the season prevalence and type of health problems was similar between sexes, the average weekly prevalence of severe health problems was higher in female than in male dancers (Chi2 = 23.2; p

Backgrounds: Satisfaction patient is indicator quality service nursing and success in fulfillment service patient. Standardized service​ already should runs on all units, fine room take care regular, and maintenance units intensive. Purpose: Study this aim for analyze influence caring training towards ability nurse manage complain. Method: Study this using a quantitative design with approach quasy experiment design with group control. Sample size are 21 nurses for every group. Group intervention given based caring training theory swanson. Before and after giving training group intervention will assessed ability nurse manage complain then compared to with group control. Results: Research result show there is significant improvement in implementation​ caring behavior of nurses in manage complain, after get training caring behavior with a mean of 11.38. behavior nurse in give service nursing this is form quality service nursing at home sick that can be influence satisfaction patient. Behavior nurse in give service expected and possible care​ satisfying patient is caring behavior, attention and treatment nurse to client with good. Conclusions: This result expected become reference strategy development for overcome problem related enhancement ability nurse manage complain with consider all over components that influence it in the field nursing.

The Secretariat of the Human Rights Commissioner of the Verkhovna Rada of Ukraine includes the Department for Monitoring the Observance of Rights in the Defense Sector and the Rights of Veterans and Servicemen, Prisoners of War and Their Family Members. The Department’s main task is to ensure that the Parliamentary Commissioner for the Observance of the Constitutional Rights and Freedoms of Servicemen exercises his or her powers. During 2022, the Human Rights Commissioner recorded a more than twenty-fold increase in appeals by servicemen regarding the violation of their rights compared to the previous year. In addition, the range of issues on which servicemen and their family members are appealing has expanded. In 2020–2021, the majority of appeals and complaints were related to military service conditions, timely payments, including adequate financial support for the families of fallen servicemen, pension recalculations, and non-compliance by the Pension Fund of Ukraine and other state bodies with court decisions restoring the rights of military personnel, military pensioners and members of their families. During 2022–2023, appeals also included the search for missing persons and the return of captives. The latter account for 72 % of all appeals. At the same time, the percentage of responses to these appeals is extremely low. The published data indicate that the Department for Monitoring the Observance of Rights in the Defense Sector and the Rights of Veterans and Servicemen, Prisoners of War and Their Family Members might not fully cover social and legal protection of these groups. The low response rate compared to the volume of complaints about human rights violations in the security and defense sector may be due to the lack of funding and the lack of qualified specialists. Given the ongoing war between the Russian Federation and Ukraine, the number of appeals will increase, and the volume of unresolved issues will most likely accumulate. Therefore, taking current realities into account, the increase in the number of servicemen and other defense sector employees, it is advisable to follow best practices worldwide and separate the institute of the military ombudsman from the institute of the Parliamentary Human Rights Commissioner. This can be done by introducing an appropriate legislative act and establishing an independent structure with expanded powers regarding veterans, prisoners of war and civilian hostages with its own financing and staff.

Abstract Background The path of a complaint and patient satisfaction with complaint resolution is often dependent on the responses of healthcare professionals (HCPs). It is therefore important to understand the influences shaping HCP behaviour. This systematic review aimed to (1) identify the key actors, behaviours and factors influencing HCPs’ responses to complaints, and (2) apply behavioural science frameworks to classify these influences and provide recommendations for more effective complaints handling behaviours. Methods A systematic literature review of UK published and unpublished (so-called grey literature) studies was conducted (PROSPERO registration: CRD42022301980). Five electronic databases [Scopus, MEDLINE/Ovid, Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL) and Health Management Information Consortium (HMIC)] were searched up to September 2021. Eligibility criteria included studies reporting primary data, conducted in secondary and tertiary care, written in English and published between 2001 and 2021 (studies from primary care, mental health, forensic, paediatric or dental care services were excluded). Extracted data included study characteristics, participant quotations from qualitative studies, results from questionnaire and survey studies, case studies reported in commentaries and descriptions, and summaries of results from reports. Data were synthesized narratively using inductive thematic analysis, followed by deductive mapping to the Theoretical Domains Framework (TDF). Results In all, 22 articles and three reports met the inclusion criteria. A total of 8 actors, 22 behaviours and 24 influences on behaviour were found. Key factors influencing effective handling of complaints included HCPs’ knowledge of procedures, communication skills and training, available time and resources, inherent contradictions within the role, role authority, HCPs’ beliefs about their ability to handle complaints, beliefs about the value of complaints, managerial and peer support and organizational culture and emotions. Themes mapped onto nine TDF domains: knowledge, skills, environmental context and resources, social/professional role and identity, social influences, beliefs about capability, intentions and beliefs about consequences and emotions. Recommendations were generated using the Behaviour Change Wheel approach. Conclusions Through the application of behavioural science, we identified a wide range of individual, social/organizational and environmental influences on complaints handling. Our behavioural analysis informed recommendations for future intervention strategies, with particular emphasis on reframing and building on the positive aspects of complaints as an underutilized source of feedback at an individual and organizational level.

Abstract Introduction Emerging infectious diseases (EIDs) can disrupt the healthcare system, causing regulatory changes that affect the healthcare-seeking process and potentially increase patient-physician dissatisfaction. This study aimed to collect and analyze patients’ and physicians’ complaints during an EID outbreak to inform potential clues regarding medical quality and patient safety enhancement in future dealing with EIDs, employing text mining methodologies. Methods In this descriptive study, complaint records from January 2020 to February 2023 at West China Hospital, a national medical facility in China, were analyzed. Patient and physician complaints have been retrospectively retrieved from the record from the medical department, and then categorized into distinct groups based on reporting reasons, encompassing COVID-19-related policies, healthcare access, availability of medical resources, and financial concerns. Results During the COVID-19 pandemic, 541 COVID-19-related complaints were identified: 330 (61.00%) from patients and 211 (39.00%) from physicians. The monthly volume of complaints fluctuated, starting at 10 in 2020, peaking at 21 in 2022, and dropping to 14 in 2023. Most complaints from inpatients were expressed by older males aged 40 to 65 (38.82%, 210/541). The primary source of complaints was related to mandatory COVID-19 policies (79.30%, 429/541), followed by concerns regarding timely healthcare services (31.61%, 171/541). Few complaints were expressed regarding the insufficiency of medical resources (2.77%, 15/541) and the high costs (4.25%, 23/541). The frequency of complaints expressed by doctors and patients in the emergency department was higher compared with other departments (24.58%, 133/541). Conclusions Increased complaints may serve as a primitive and timely resource for investigating the potential hazards and drawbacks associated with policies pertaining to EIDs. Prompt collection and systematical analysis of patient and physician feedback could help us accurately evaluate the efficacy and repercussions of these policies. Implementing complaints-based assessment might improve care standards in forthcoming healthcare environments grappling with EIDs.

Abstract Background Several studies have investigated injuries of (pre-)professional ballet dancers, however most used a medical-attention and/or time-loss definition and did not analyse the prevalence of all health problems. The aim was to analyse the frequency and characteristics of all self-reported physical and mental health complaints (i.e. injuries, illnesses and mental health problems) of professional ballet dancers during one season. Methods Three professional ballet companies were prospectively monitored weekly during one season with the Performing artist and Athlete Health Monitor (PAHM). Numerical rating scales (ranging 0–10) were used for severity of musculoskeletal pain, all health problems and impairment of the ability to dance at full potential in the previous seven days. If dancers rated the severity of their health problems or their impairment greater than 0, they were asked to answer specific questions on the characteristics of each health problem. Results Over a period of 44 weeks, 57 dancers (57.9% female) filled in 1627 weekly reports (response rate of 64.9%), in which 1020 (62.7%) health problem were registered. The dancers reported musculoskeletal pain in 82.2% of the weeks. They felt that their ability to dance at their full potential was affected due to a health problem in about every second week (52.6%) or on at least 29.1% of the days documented in the weekly reports. Almost all dancers (96.5%) reported at least one injury, almost two thirds (64.9%) an illness and more than a quarter (28.1%) a mental health problem. On average, every dancer reported 5.6 health problems during the season. Most of the 320 health problems were injuries (73.1%), 16.9% illnesses and 10.0% mental health problems. Injuries affected mainly ankle, thigh, foot, and lower back and were mostly incurred during rehearsal (41.6%) or training (26.1%). The most frequent subjective reasons of injury were “too much workload” (35.3%), “tiredness/exhaustion” (n = 22.4%) and “stress/overload/insufficient regeneration” (n = 21.6%). Conclusion Preventive interventions are urgently required to reduce the prevalence of health problems and especially injuries of professional dancers. Injury prevention measures should regard the balance of the load capacity of professional dancers and the workload in training, rehearsals and performances.

The traditional researcher’s view of Russian history is based on the metropolitan point of view even if the object of study is one of the country’s regions. This is the case because all the main decisions are made in the capital, and therefore it is the state institutions that not only produce but also store the bulk of the documents. But if we turn to regional materials, we can see that the Soviet homogeneity was in fact replaced by heterogeneity. On this basis, the question can be raised to what extent the spatial and geographical factors should be taken into account in the study of the Soviet experience. The formation of a new Soviet subject was an important aspect of the Soviet system. In addition to labor activity, this new Soviet man had to be an active subject in social life as well, contributing to the maintenance of normative order. Letters to the authorities were a form of such struggle for norm and morality. The Soviet system presupposed the possibility of criticizing individual shortcomings in the field as long as the order itself was not questioned. But in the late-Soviet period, moral norms began to be actively extended to the entire Soviet population, not just the high-ranking party officials. This was largely due to the ideas of expanded state management during the transition from socialism to communism and the involvement of the broad masses in this process. The late-Soviet period was marked by the replacement of organized mass violence by various forms of soft control and by building a system of social control. This approach largely coincides with the concept of the moral economy, which was formulated by Edward Palmer Thompson. Even if we do not consider the mass protests that were not uncommon in the USSR, a significant number of appeals and complaints from citizens can be seen as a manifestation of the moral economy. That is, citizens did not seek to break the existing rules of the game but, on the contrary, tried to bring the reality around them to the ideas of morality and justice that were common in various groups of Soviet society.

Background: Unsolicited patient feedback (compliments and complaints) should allow the healthcare system to address and improve individual and overall patient, family, and staff experiences. We evaluated feedback at a tertiary cancer centre to identify potential areas for optimizing care delivery. Methods: unsolicited feedback submitted to the Patient Relations Department, relating to the Divisions of Medical and Radiation Oncology, at the Ottawa Hospital, was analyzed. Results: Of 580 individual reports submitted from 2016 to 2022, patient demographics were available for 97% (563/580). Median patient age was 65 years (range 17–101), and 53% (301/563) were female. The most common cancer types were breast (127/545, 23%) and gastrointestinal (119/545, 22%) malignancies, and most (64%, 311/486) patients had metastatic disease. Feedback was submitted mainly by patients (291/579, 50%), and predominantly negative (489/569, 86%). The main reasons for complaints included: communication (29%, 162/566) and attitude/conduct of care (28%, 159/566). While feedback rates were initially stable, an increase occurred from 2019 to 2021. Conclusions: Unsolicited feedback remains mostly negative, and relates to physician communication. If we are to drive meaningful changes in care delivery, more standardized means of assessing feedback and implementation strategies are needed. In addition, in an era of increased healthcare provider burnout, strategies to enhance formal positive feedback are also warranted.

Abstract Background It is uncertain if patient’s characteristics are associated with complaints and claims against doctors. Additionally, evidence for the effectiveness of remedial interventions on rates of complaints and claims against doctors has not been synthesised. Methods We conducted a rapid review of recent literature to answer: Question 1 “What are the common characteristics and circumstances of patients who are most likely to complain or bring a claim about the care they have received from a doctor?” and Question 2 “What initiatives or interventions have been shown to be effective at reducing complaints and claims about the care patients have received from a doctor?”. We used a systematic search (most recently in July 2023) of PubMed, Scopus, Web of Science and grey literature. Studies were screened against inclusion criteria and critically appraised in duplicate using standard tools. Results were summarised using narrative synthesis. Results From 8079 search results, we reviewed the full text of 250 studies. We included 25 studies: seven for Question 1 (6 comparative studies with controls and one systematic review) and 18 studies for Question 2 (14 uncontrolled pre-post studies, 2 comparative studies with controls and 2 systematic reviews). Most studies were set in hospitals across a mix of medical specialties. Other than for patients with mental health conditions (two studies), no other patient characteristics demonstrated either a strong or consistent effect on the rate of complaints or claims against their treating doctors. Risk management programs (6 studies), and communication and resolution programs (5 studies) were the most studied of 6 intervention types. Evidence for reducing complaints and medico-legal claims, costs or premiums and more timely management was apparent for both types of programs. Only 1 to 3 studies were included for peer programs, medical remediation, shared decision-making, simulation training and continuing professional development, with few generalisable results. Conclusion Few patient characteristics can be reliably related to the likelihood of medico-legal complaints or claims. There is some evidence that interventions can reduce the number and costs of claims, the number of complaints, and the timeliness of claims. However, across both questions, the strength of the evidence is very weak and is based on only a few studies or study designs that are highly prone to bias.

Abstract Background Aronia melanocarpa is a berry rich in polyphenols known for health benefits. However, the bioavailability of polyphenols has been questioned, and the individual taste acceptance of the fruit with its specific flavor varies. We recently observed substantial differences in the tolerability of aronia juice among healthy females, with half of the individuals tolerating aronia juice without complaints. Given the importance of the gut microbiome in food digestion, we investigated in this secondary analysis of the randomized placebo-controlled parallel intervention study (ClinicalTrials.gov registration: NCT05432362) if aronia juice tolerability was associated with changes in intestinal microbiota and bacterial metabolites, seeking for potential mechanistic insights into the impact on aronia polyphenol tolerance and metabolic outcomes. Results Forty females were enrolled for this 6-week trial, receiving either 100 ml natural aronia juice (verum, V) twice daily or a polyphenol-free placebo (P) with a similar nutritional profile, followed by a 6-week washout. Within V, individuals were categorized into those who tolerated the juice well (Vt) or reported complaints (Vc). The gut microbiome diversity, as analyzed by 16S rRNA gene-based next-generation sequencing, remained unaltered in Vc but changed significantly in Vt. A MICOM-based flux balance analysis revealed pronounced differences in the 40 most predictive metabolites post-intervention. In Vc carbon-dioxide, ammonium and nine O-glycans were predicted due to a shift in microbial composition, while in Vt six bile acids were the most likely microbiota-derived metabolites. NMR metabolomics of plasma confirmed increased lipoprotein subclasses (LDL, VLDL) post-intervention, reverting after wash out. Stool samples maintained a stable metabolic profile. Conclusion In linking aronia polyphenol tolerance to gut microbiota-derived metabolites, our study explores adaptive processes affecting lipoprotein profiles during high polyphenol ingestion in Vt and examines effects on mucosal gut health in response to intolerance to high polyphenol intake in Vc. Our results underpin the importance of individualized hormetic dosing for beneficial polyphenol effects, demonstrate dynamic gut microbiome responses to aronia juice, and emphasize personalized responses in polyphenol interventions. Graphical Abstract Video Abstract

Background: No matter which benefit option members have chosen, medical schemes are required by the Medical Schemes Act no. 131 of 1998 to pay costs associated with the diagnosis, treatment, or care of a specified set of benefits known as Prescribed Minimum Benefits (PMBs). Medical scheme beneficiaries have the right to lodge complaints with the Council for Medical Schemes (CMS) when their claims are denied. Objective: To determine and describe the pattern of PMBs complaints received by CMS from January 2014 to December 2018. Methods: This was a cross-sectional study that utilised the CMS’ clinical complaints. Data for PMBs, complainants, medical scheme types, and reasons for payment denial were extracted. The CMS’ lists of chronic conditions, PMBs, and registered schemes were used to confirm PMBs and to categorise schemes as either restricted (i.e., to only members of specific organisations) or open (i.e., to all South Africans). Extracted and coded data were analysed using SAS v.9.4 software. Results: A total of 2141 complaints were retrieved and 1124 PMBs complaints were included in the study. The median of PMBs complaints per year was 225. Most of the complaints (43.6%, n=490/1124) were lodged by members themselves. Non-Communicable Diseases (NCDs) constituted most of the PMBs conditions that members complained about. Medicine and surgery were the services that were mostly denied full payment by medical schemes. Open medical schemes accounted for more (73.8%, n=830/1124) of the complaints. Conclusion: Chronic conditions are the main diseases that medical scheme members complained about. Member education and clear definition of PMBs should be prioritised by medical schemes and the Council for Medical Schemes.

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 7 years. 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.

In today’s digital society, social networks such as Twitter are a preferred place for expressing one’s emotions, especially when they are negative. Despite a growing interest in the variety of linguistic realizations of commuters’ complaints, little attention has so far been paid to writers’ choices, especially when morphologically or syntactically simpler alternative formulations are available. A typical example is the “inference towards the antonym” triggered by the negation of contrary adjectives, an effect that is stronger for positive compared to negative adjectives. In the context of railway transport, a customer could use the negative statement The train is not clean instead of the corresponding affirmative sentence The train is dirty. It remains unclear, in our current state of knowledge, why online customers would prefer more complex constructions to voice their criticisms. Based on a large corpus of tweets sent to the French and Belgian national railway companies by their customers, I have semi-automatically extracted instances of not (very) + adjective (ADJ). Based on previous observations in the literature, I expected positive adjectives to be more frequently used in these negative environments compared to negative ones. As recent research demonstrates that one’s desire to save the interlocutor’s face is not necessarily the only reason why positive adjectives are used in linguistically negative environments, other motivations will also be considered. More precisely, I suggest that in a context where negativity is prevalent, customers using negated positive adjectives kill two birds with one stone: not only do they signal an issue with a product or a service, pointing to expectations that have not been met by the company, but they also mitigate the impact of their negative comments to the positive face of the service managers with whom they are interacting. By offering a quantitative, corpus-based analysis of negative constructions, complemented by a qualitative linguistic analysis of selected examples, this research sheds new light on users’ lexical choices in online negative customer feedback.

Background and objectives: Anesthesiologists and hospitals are increasingly confronted with costs associated with the complications of Peripheral Nerve Blocks (PNB) procedures. The objective of our study was to identify the incidence of the main adverse events associated with regional anesthesia, particularly during anesthetic PNB, and to evaluate the associated healthcare and social costs. Methods: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic search on EMBASE and PubMed with the following search strategy: (“regional anesthesia” OR “nerve block”) AND (“complications” OR “nerve lesion” OR “nerve damage” OR “nerve injury”). Studies on patients undergoing a regional anesthesia procedure other than spinal or epidural were included. Targeted data of the selected studies were extracted and further analyzed. Results: Literature search revealed 487 articles, 21 of which met the criteria to be included in our analysis. Ten of them were included in the qualitative and 11 articles in the quantitative synthesis. The analysis of costs included data from four studies and 2,034 claims over 51,242 cases. The median claim consisted in 39,524 dollars in the United States and 22,750 pounds in the United Kingdom. The analysis of incidence included data from seven studies involving 424,169 patients with an overall estimated incidence of 137/10,000. Conclusions: Despite limitations, we proposed a simple model of cost calculation. We found that, despite the relatively low incidence of adverse events following PNB, their associated costs were relevant and should be carefully considered by healthcare managers and decision makers.

The article raises certain aspects of organizing the nationwide discussion of the Draft Soviet Constitution of Developed Socialism of 1977 at the regional level. Using as example of the Councils of Ministers of three autonomous republics of the Volga region the Mari, Mordovian and Chuvash Autonomous Soviet Socialist Republics, the actions of the regional governments to implement the directives of higher authorities and take into register critical applications, appeals and complaints of Soviet citizens. For this purpose, unpublished documents from the State Archive of the Republic of Mari El, the State Historical Archive of the Chuvash Republic, and the Central State Archive of the Republic of Mordovia were used as the main source of scientific work. These included resolutions of the Councils of Ministers of the Autonomous Republics, certificates and reports of the organizational and instructor departments of the Councils of Ministers on consideration of citizens appeals, correspondence with authorities, etc. When processing these materials, the method of content analysis, historical-systemic, comparative-historical methods were used. Based on the conducted research, the author comes to the conclusion that despite the formalized nature of the nationwide discussion, it carried not only a purely ideological function, but also solved a rather significant practical task of establishing a feedback between the authorities and society. The Councils of Ministers of the ASSR collected and analyzed information on citizens critical appeals received by subordinate agencies, and then took measures to solve many economic, domestic and social problems that worried the Soviet people

This article focuses on the legal policy of constitutional complaints in judicial review. It compares the European model (Germany, Austria, Hungary) and Indonesia. These four countries have a legal policy in common, a constitutional court with a centralised court system and judicial review (abstract judicial review, concrete judicial review, and constitutional complaints), but the MKRI lack constitutional complaint. Three constitutional complaints policies in these courts can be used as a reference for the strengths and weaknesses of each judiciary on regulations and legal practices. However, Germany's constitutional complaints policy is better than Austria's and Hungary's. Its excellence is caused all ordinary court decisions as an object dispute; decisions are final and binding; individuals and organisations can submit this application and legal aid by the lawyers or professor of law in the oral hearing; the process only takes one month and is free of charge and the trial with or without an oral hearing. In the future, MKRI needs this authority with legal policy steps amending the MKRI Act, and the last step is an amendment to the 1945 Constitution.

A systematic approach to nonconformity management and continuous improvements are the key elements of the quality management system. The objective of this paper is to present quality improvement for a manufacturing company producing forgings through the combination of several statistical methods and quality control techniques. First, Pareto analysis was applied, followed by the 8D (eight disciplines) methodology using a structured eight-step approach to problem solving following the PDCA (plan-do-check-act) method. The aim was to identify the problem and discover the critical causes of failures in the management system that allowed the problem to occur, by modifying and combining appropriate quality management methods and tools. The paper introduces a case study considering the forging process in the production of gearboxes, where customer complaints were identified in the last year, demanding the need to eliminate failures. Using the mentioned methods, the root cause of the problem was identified and permanent corrective action was planned and implemented according to the recommendations of the 8D report, which made it possible to reduce the likelihood of a recurrence of this problem and increase customer satisfaction.

Based on the understanding of the criminal procedure as a means for the protection of rights and freedoms of the individual involved in criminal proceedings, the authors consider unresolved problems and the most topical issues for theory and practice of petitions and complaints in this field. Petitions and complaints are given the appropriate place of a fundamental element in determining the essence of criminal procedure. Purpose: based on the modern understanding of the aim of criminal procedure, to formulate the main directions of the study of the legal institution of petitions and complaints in order to determine their place in the system of theoretical knowledge and in practice. Methods: system analysis, formal and dialectical logic, interpretation of legal norms, comparative historical, comparative legal. Results: the study reveals the relevance of petitions and complaints to the purpose of criminal proceedings, which is to protect the rights and freedoms of persons involved in criminal proceedings. The institution in question, previously underestimated, plays a significant and sometimes decisive role in society’s assessment of the effectiveness of criminal procedure activities in modern conditions. The main lines of scientific researches are identified, which should eventually lead to the development of a full-fledged mechanism for exercising the right to petitions and complaints as a universal and specific legal means that ensures that criminal procedure activity complies with its purpose and the demands of civil society.

Abstract Background The nose is one of the most prominent parts of the face and plays a significant role in peoples’ self-satisfaction as well as quality of life. Rhinoplasty is considered as one of the most numerous and delicate cosmetic surgeries all around the world that can be performed for functional issues, esthetic issues, or both. In this study, we aimed to evaluate the dissatisfaction of patients who had undergone rhinoplasty surgery and inform the surgeons to improve the surgical techniques to prevent probable future complaints. Method This retrospective cross-sectional study was conducted to report various aspects of dissatisfaction of patients following rhinoplasty. All available files in the Fars Forensic Medicine Department between 2011 and 2020 were reviewed, and the required information was extracted. Results Out of 117 patients, 68.4% were females and 31.6% were males. Most of the patients were in the age range of 30–34 years. In terms of educational attainment, the highest frequency is associated with academically educated patients and the lowest with a diploma. The majority of cases filed for litigation less than 6 months after their rhinoplasty. The first rank among the factors of dissatisfaction with surgeries belonged to “respiratory problems” (36.8%) followed by “dissatisfaction with the general shape of the nose” (34.2%). Conclusion Our study shows that middle-aged female patients may be more difficult to satisfy. In general, at younger ages, patients complain about esthetics, and with aging, most patients feel dissatisfied with nasal function.

As future service providers, students in the Degree of Tourism need to adequately perform in their L2 in very specific professional settings. One of them is that of service encounters, whose mediated nature has become predominant nowadays. The present study aims to contribute to the existing body of research on the review response genre by analyzing how Spanish students of tourism respond to a group of complaints from TripAdvisor (Vásquez, 2011; Zhang and Vásquez, 2014). This will be done by placing the focus on the moves (Ho, 2017a) employed by the students, as well as the sequence in which they are used. The ultimate goal is to determine if these potential service providers’ selection of moves and their order coincide with those normally used by actual hotel representatives (Ho, 2017a).

The background of this research is the maladministration of Makassar Polrestabes services which can be seen in public complaints to the Ombudsman. The research problem is how responsive the handling of public complaints is. This study aims to determine the responsiveness in handling complaints in accordance with the provisions of the regulations. The approach used is a qualitative method with a phenomenological type, data obtained from informants namely the head and assistants of the RI Ombudsman Representative for South Sulawesi, Makassar Police Chief and staff, and the reporting community. Collecting data through interviews, observation and document review. The Miles and Huberman model interactive data analysis through the process of data reduction, data presentation, and inference/verification. The results of the study found three aspects of service responsiveness, namely input responsiveness, process responsiveness, and output responsiveness. All three have been carried out well based on work patterns that refer to applicable regulations. In the aspect of input responsiveness, the reporting community still complains because it is constrained by administrative and substantive requirements so that the report is not processed to the case register stage. Settlement of public complaints regarding maladministration of Makassar Polrestabes services is resolved with recommendations for clarification, mediation or conciliation, by providing understanding to the public on the service process. To increase responsiveness, the Ombudsman needs to carry out intensive socialization and assistance to parties affected by maladministration.

The difficult situation of the agricultural and food supply chainin the European Union, regarding both commercial practices and the differentbargain powers of the parties to the chain, led to the enactment of Directive2019/633. The Directive provides for minimum harmonization and its transpositioninto the Spanish legal order has been complex and fragmentary. Parts of thattransposition raise doubts as per their pertinence and seem to lack ambition.This article discusses the difficulties in assessing the extent to which the Spanishtransposition of the Directive remained within its goals and objectives. It arguesthat the Spanish legislator might have gone beyond the objectives of theDirectives and entered other regulatory areas.

Based on data from the CORONA-MONITORING lokal (CoMoLo) study conducted in four municipalities particularly affected by the COVID-19 pandemic, this article investigates the non-utilisation of health care services in the population aged 18 years and older (n=9,002) in relation to the period after the introduction of the containment measures in March 2020. The results show that about one third of the respondents (35.5%) gave up at least one of the surveyed health care services. The most frequent cancellations were dental (15.2%) and specialist check-ups (11.8%), followed by postponement of physiotherapy, ergotherapy or speech therapy (6.1%), cancellation of general practitioner (GP) check-ups (5.8%), postponement of psychotherapy (2.0%), postponement of planned hospital treatment (1.8%) and not going to an emergency room (0.7%). Almost 10% of the respondents reported not visiting a physician despite health complaints. Compared to respondents without such a waiver, these respondents were more often female and younger than 35 years, less often rated their health as very good or good, more often had a diagnosis of depression and more often used telemedical contacts as an alternative to visiting the practice during the pandemic. Further analyses of trends in utilisation behaviour and changes in health status over the course of the COVID-19 pandemic are important.

Abstract Background Veterinarians and support staff have been reporting the negative mental health effects from client complaints (CC). A previous study was performed evaluating these effects in veterinarians however no such study has been performed on veterinary support staff (VSS). Objectiv The purpose of this study was to investigate the frequency and effects of CCs on VSS. Methods A cross sectional anonymous survey using a web‐based questionnaire was created evaluating the frequency, type, and effects from CC. The survey was distributed to five different VSS Facebook groups and respondents provided demographic information and reported the frequency and effects of such complaints. Results A total of 681 questionnaires were collected during the study period but 130 were incomplete and were excluded from analysis. This resulted in 551 completed questionnaires available for review. One hundred and ninety (34.4%) VSS reported being subject to a CC in the previous 6 months with cost of care the most common reason (78.6%). Two hundred and sixty VSS (47.2%) reported feeling depressed because of CCs made against them, 295 VSS (53.5%) stated CCs negatively affected their enjoyment of their job, and 146 (26.5%) have considered changing their career because of CCs. Conclusions CC have detrimental effects on VSS career satisfaction, mental health and hospital practices. Further studies are warranted to mitigate the detrimental effects of CCs.

A major concern related to the healthcare industry is uniformity in healthcare delivery. There is considerable variation in the diagnosis and treatment of patients depending on the experience and expertise of the doctors. Information technology can play a major role in addressing this issue. Research investigating the use of data-driven approaches and knowledge-driven clinical pathways to achieve uniformity in the delivery of healthcare is ongoing. Specifically, the integration of data and knowledge-driven approaches can be used to ensure uniformity in the delivery of patient care, thus avoiding inappropriate variance. The data-driven approach can utilize the bulk of medical data being generated. The knowledge-driven approach in the form of clinical pathways incorporates evidence-based care. In this context, knowledge and data-driven computerized physician order entry (CPOE) systems are gaining importance in healthcare delivery systems. This paper proposes a knowledge and data-driven framework for a CPOE system. This work is based on a knowledge base populated with disease quadruples, each of which comprises a list of symptoms, tests, results, and medications for a particular disease. The data used in the proposed system are obtained from two datasets, namely, the MIMIC (Medical Information Mart for Intensive Care) and the Disease-Symptom Knowledge Database, which is based on the operational data of New York-Presbyterian Hospital (NYPH). We combined both datasets using the common attribute of disease to generate data with more attributes to aid decision making. This was performed with the help of specialists and clinical knowledge. The resulting patient data are further integrated with clinical pathways before the extraction of disease quadruples. The novelty of this work lies in the extraction of disease quadruples from the integration of patient data with clinical pathways. The list dynamically ranks each element of the quadruple based on its association score to facilitate the generation of prescription order sets for the CPOE. The effectiveness of the proposed system in providing uniform patient care delivery has been validated by experts. The proposed system can significantly improve patient safety and the quality of healthcare delivery due to the integration of data-driven capability with clinical pathways.

The media currently limit public complaints, and some people find it difficult to convey or report events in the area. Complaints are still not fully using information technology media. This makes it difficult for the public to provide suggestions or submit complaints. The authors developed an information system for the public complaint process using the waterfall method from these problems. This system aims to create a Jatibaru village website and create a complaint website for the community so that complaints in the community can be conveyed properly through the complaints website. The public can review the complaints to determine whether the complaints have been processed or not. System development using the PHP and HTML programming languages. The final result of this study resulted in a public complaint information system so that the aspirations of the community were properly conveyed to the village government, all complaints would be discussed by the village apparatus to minimize complaints from the community, and with this system, it can also help monitor complaints submitted by the community.

The article analyses the ways of appealing against judgments issued by the land and mortgage register court. The lodging of appeals always extends the proceedings aimed at obtaining a legally binding entry in the land and mortgage register. From the perspective of real estate participants, it is also necessary to mention that the elimination of an entry in the register may also take place by bringing an action regarding the property right for which the land and mortgage register is kept. A common court judgement may also have the effect of making an entry in the land and mortgage register with a content different than that resulting from the examination of the application for entry, and then the means of appealing against it, by the land and mortgage register court.

ABSTRACT BACKGROUND: Dermatitis herpetiformis (DH) is considered a skin celiac disease (CD). The individuals can be seen by primary care professionals or by dermatologists that could refer the patient to a gastroenterologist. OBJECTIVE: The study aimed to investigate the clinical profile of patients diagnosed with DH and referred to a gastroenterologist and evaluate the treatment response. METHODS: We retrospectively studied patients with DH referred to the same gastroenterologist at a private office in Curitiba, Brazil, between January 2010 to December 2019. We included adult patients with a confirmed DH diagnosis. Symptoms, clinical signs, laboratory and histological data, as well as treatment response, were collected. RESULTS: Thirty-three patients were studied (60.6% women, mean age at diagnosis 40.8±12.61 years). The median delay for DH diagnosis was four years. Skin involvement was mild in 33.3%, moderate in 18.2%, and severe in 48.5%. The more frequent gastrointestinal complaints were abdominal distension (78.8%), flatulence (75.7%), and gastroesophageal reflux (51.5%). Depression and anxiety were observed in 81.8% and anemia in 51.1%. A higher prevalence of bone disorders was associated with higher age at DH diagnosis (P=0.035). Duodenal biopsy showed changes in all patients. Improvement after treatment only with a gluten-free diet (GFD) plus dapsone was verified in 81.2%. CONCLUSION: Patients with DH referred to a gastroenterologist showed a high frequency of gluten intolerance and systemic complaints. Duodenal histological alterations were found in all the cases. The treatment based on GFD plus dapsone was effective in most patients.

Background Whistleblowing can bring suspected wrongdoing to the attention of someone who is in the position to rectify the problem. Whistleblowing research can help improve effectiveness of anti-corruption efforts in the health sector. Objective The objective of this scoping review is to understand the extent and type of evidence on whistleblowing as an anti-corruption strategy in health and pharmaceutical organisations in low- and middle-income countries (LMICs). Methods This scoping review searched the PubMed, Scopus, and EMBASE databases from 2005 to 2020, limited to English language. We also searched websites of multilateral agencies or international non-governmental organisations for policy documents, guidance and reports. Titles and abstracts were screened to remove those where the focus was not on health, pharmaceuticals, whistleblowing, or LMIC context. Articles focused on research misconduct were excluded. Full-text articles were assessed for eligibility on these same criteria. Included sources were analysed thematically, based on five categories including definitions and models; evidence of reporting frequency; factors influencing whistleblowing; cultural context; and outcomes. Results The review found 22 sources including reports, policies, and guidance documents (12, 55%), news articles (4, 18%), policy analyses/reviews (3, 14%), commentaries (2, 9%), and empirical studies (1, 5%). Most sources described whistleblowing policy and system components such as how whistleblowing is defined, who can report, and how confidentiality is assured. Few articles documented types and frequencies of corruption identified through whistleblowing or factors associated with whistleblowing. Several studies mentioned cultural norms as a potential limitation to whistleblowing effectiveness. About one-third of the sources described fear of retaliation and noted the need to strengthen protection for whistleblowers. Conclusion Research on whistleblowing is scarce in health and pharmaceutical organisations in LMICs. Documentation of policies, factors associated with whistleblowing, and whistleblowing outcomes is needed and could help countries to mainstream whistleblowing as a sectoral anti-corruption strategy.

The practice of chain remand would cause human rights violations if the application was granted without reasonable cause and reason. This chain remand problem was tried to be addressed in 2007, which was amongst the factors that led to the amendment of the Criminal Procedure Code (CPC) at that time due to the defilement of human liberty. In Malaysia, there are governmental and non-governmental bodies that are active in ensuring that the human rights of the entire community are protected from being violated. The issue of wrongful detention involving chain remand during an investigation is not a new issue. This issue is constantly highlighted and efforts to address it are often raised by the responsible parties. This study aims to analyse the roles of these bodies in dealing with chain remand complaints in Malaysia using a qualitative research approach by way of in-depth interviews, roundtable discussions, and document analysis. The study discovered that these human rights bodies in Malaysia were able to investigate the complaints, but did not have a role to take any actions. Their role is only to provide recommendations to the complainants to take action. Therefore, this study recommended establishing a legal provision with respect to the power to impose prosecution or disciplinary action on the officers involved in illegal detention without due cause. This study also suggests the function should be given to the prosecution department to take action to curb the problem based on solid evidence.

The use of a systematic approach to the study of the etiology of a certain pathology makes it possible to improve the understanding of its pathogenesis, as well as to develop more effective diagnostic and therapeutic approaches, including improving the prediction of its risk. Within this review, we will consider such an area of interdisciplinary research as neurocardiology, which studies the brain-heart axis. Examples of cardiovascular diseases associated with organic and functional disorders of this axis will be considered, as well as the prospects for research in this area and their translational significance for clinical medicine.

In most countries, a veterinary disciplinary system is in force to ensure the quality of the veterinary profession and to offer an objective platform for complaints. We present an analysis of 15 years of veterinary disciplinary verdicts (2001–2016) to compare facts and figures and identify which factors are of major influence on the outcome of the verdicts. Rulings were collected from both paper files and the digital database of the veterinary disciplinary council (VDC), categorized, and used to create a database that enabled a statistical analysis. The results showed that complaints pertaining to companion animals are filed predominantly by owners, whereas complaints about livestock are mostly filed by the governmental civil servant (CS). CS complaints mostly address compliance issues. For the complaints made by owners (client complaints, CCs), reporting, communication, and veterinary mistakes appeared to be of statistical significance. Further studies are needed to investigate the impact of the complaints on veterinarians in general and how we can improve the veterinary disciplinary system.

Overstretched resources and steady increases in the number of complaints filed with the offices of the Quebec Service Quality and Complaints Commissioner prompted us to investigate the complaint-handling systems of health-related organizations operating in Commonwealth and Western European countries. We also examined guidelines used to identify higher priority files (i.e., urgent files). Urgent files can then be prioritized in terms of the time taken to provide a conclusion as well as the depth of the examination. A system where a small fraction of complaints is deemed “urgent” was preferred over systems where complaints are categorized into three or more priority levels, because files categorized in the lowest of three or more priority levels risk being neglected. Applying lessons from other systems and considering the Service Quality and Complaints Commissioner’s mandate, we identified three guiding criteria for determining whether files warrant urgent status: threat to safety, involvement of vulnerable person(s) and risk of recurrence (but only when coupled with safety issues). Since determining which files should be considered urgent is not straight forward, these broad criteria can be adapted and applied on a case-by-case basis.

This commentary invites reflection on the positive and negative outcomes of “assistances” provided by a Complaints Commissioner. While the goal of an assistance is to help the user navigate the health system, a lack of clarity and understanding of the process can lead to the user obtaining undue privileges. We suggest three key values to guide the equitable conduct of assistances and we suggest a mixed method research methodology to document the positive and negative impacts of assistances.

Bioethicists have long advocated for patients’ rights by deliberating on what physicians should or should not do for the well-being of patients. Part of this advocacy has involved challenging a paternalistic medical model where physicians are seen as authoritative figures above reproach. Through ombudsperson offices, patients can submit complaints that may lead to medical examiners conducting detailed examinations of physicians’ conduct and decision-making. Prior research indicates that complaints can have serious and broad effects on physicians. We conducted a scoping review to explore and evaluate the extent of the quantitative and qualitative literature examining the effects of complaints on physicians in European and Commonwealth countries. We systematically searched electronic databases (CINAHL, MEDLINE and PsycInfo) and grey literature for primary research that collected information directly from physicians on at least one potential effect of formal complaints. After screening the titles/abstracts of 14,913 records and reviewing 137 full-texts, 25 studies were included. The 25 studies reported on several potential effects, including the patient-physician relationship (3 studies), defensive medicine (14 studies), anxiety (8 studies), depression (8 studies), one’s identity as a physician (5 studies), and anger (5 studies). Generally, the effects evaluated in the included studies were negative. Although the existing literature covered a range of possible effects, few studies assessed the same effects via different methods, and in different regions and contexts. The findings of this scoping review suggest that complaints processes can have negative effects on physicians.

In this case study, we describe an approach to dealing with a complicated, systemic, and multi-faceted organizational issue: the continuum of maternal care from antepartum care, birthing, to post-natal care.

The fundamental problems with component production in the automotive industry are the low quality of the components, the high number of failures, and the subsequent number of complaints. The quality of automotive components is a prerequisite for automated production in a SMART Factory 4.0 in the context of Industry 4.0. Managing complaints is a critical area in the automotive manufacturing industry. The primary goal of this article is to indicate the significance of a CRM system and the importance of complaints management in automotive manufacturing, which improves the quality of the process of producing components while improving the quality of the inputs—the quality of materials, the quality of the human factor, and the quality of the services provided in connection with the components. (1) A Slovak company was selected as the subject of this research, which focuses on the production of automotive parts. (2) The methods of research focused on using economic analysis and instruments of quality management such as the QRQC method, FMEA method, the Ishikawa diagram, and the Pareto analysis and Lorenz curve. This article presents the results of complaints about automotive components: locksets in vehicles. (3) This research shows the basic cause of the problem: a bent pin after riveting in the process of producing the components. In the frame of this research, we suggested corrective measures to eliminate the actual causes of failure in the production of the components. The RPN index reached a level below the limit of 150 (the critical level of the customers’ requirements) after implementing the corrective measures. The total costs of complaints in this year were calculated to be EUR 13.575 and the costs will be reduced gradually after changes are implemented in the production process. (4) A new complaints information system and a new training center are beneficial for solving problems in the production of automotive components. The implementation of a CRM system and other systems are prerequisites for solving customer complaints.

The research focuses on the proposal of a Constitutional Complaint for the Indonesian Constitutional Court. The background causes of the constitutional weakness to protection and fulfilment of constitutional rights, especially the absence of a Constitutional Complaint mechanism. Research methods used normative legal research methods with statutory, analytical, and case approaches. The study results show that legal thinking, including an embodiment of the values of constitutionalism in the rule of law of Pancasila, complements a checks and balances system, the basis for protecting fundamental rights, and aims to realize good governance. There are several steps/ methods to giving this authority, amendments to the 1945 Constitution, non-original interpretations, and revision of the Constitutional Court Act. Several objects of dispute are the Court’s verdict, the problems of interpreting the 1945 Constitution and law by a state official, People Consultative Assembly decisions, and others.

Complaints reflect a person’s or family’s experience within the aged care system and provide important insight into community expectations and consumer priorities. Crucially, when aggregated, complaints data can serve to indicate problematic trends in care provision. Our objective was to characterize the areas of medication management most frequently complained about in Australian residential aged care services from 1 July 2019 to 30 June 2020. A total of 1134 complaint issues specifically referenced medication use. Using content analysis, with a dedicated coding framework, we found that 45% of these complaints related to medicine administration processes. Three categories received nearly two thirds of all complaints: (1) not receiving medication at the right time; (2) inadequate medication management systems; and (3) chemical restraint. Half of the complaints described an indication for use. These were, in order of frequency: ‘pain management’, ‘sedation’, and ‘infectious disease/infection control’. Only 13% of medication-related complaints referred to a specific pharmacological agent. Opioids were the most common medication class referred to in the complaint dataset, followed by psychotropics and insulin. When compared to complaint data composition overall, a higher proportion of anonymous complaints were made about medication use. Residents were significantly less likely to lodge complaints about medication management, probably due to limited engagement in this part of clinical care provision.

Background: Occupational skin illnesses are the second most common occupational health hazard following musculoskeletal disorders. Tannery workers have frequent and prolonged exposure to skin irritants and allergens and may have a higher risk of developing occupational dermatitis. Aims and Objectives: The aim of this study is to examine the extent of skin problems and their determinants among male tannery workers. Materials and Methods: The data for the present research was drawn from a cross-sectional household study of tannery and nontannery workers in the Jajmau area of Kanpur, Uttar Pradesh. A total of 284 tannery and 289 nontannery workers were interviewed using purposive sampling technique. Descriptive statistics and multivariate techniques have been used. Results: Tannery workers experienced itching hands or fingers with fissures (21%), scaling of hands or fingers with fissures (18%), red and swollen hands or fingers (11%), and vesicles on the hands or between the fingers (11%). The workers who had moderate/high dermal exposure to chemicals were 35(P < 0.001), and they were 31 (P < 0.001) times more likely to experience vesicles on scaling hands or fingers with fissures, and itching hands or fingers with fissures. The tannery workers engaged in wet finishing work were significantly 3.9 (P < 0.1) times more likely to experienced scaling on hands or fingers with fissures. Conclusion: The study acclaims the mechanization of tannery activities at workplaces, so that risk of skin complaints can be minimized among tannery workers. As the risk of skin complaints is very high with the dermal exposure to chemicals, personal protective equipment must be provided and their use should be included in the curriculum of the ternary workers.

Background. The relevance of the study is determined by the need to obtain qua-litatively new and diverse knowledge that contributes to the formation of an objective assessment of the activities of health authorities and institutions during the war period. The purpose of the study is to reconstruct the hospital everyday life of Penza region at the final stage of the Great Patriotic War based on the complaints from wounded Red Army soldiers. Materials and methods. The study is based on the analysis of documents from the State Archives of Penza Region, as well as materials from local and central periodicals. The central place is occupied by the complaints of servicemen who were treated in evacua-tion hospitals of the Penza region in 1944–1945. Documents of an earlier period (for 1941–1943) and any statistical data on the number and problems of appeals in the regional archive are not presented. The analysis of the specified corpus of sources makes it possible to reconstruct the daily history of evacuation hospitals in the “dimension” of direct recipi-ents of medical care – wounded soldiers of the Red Army. The description of the adaptation practices of the wounded and sick, presented in the complaints, needs to be correlated with the assessments of employees of hospitals, public organizations and government agencies. Results. Some aspects of the source analysis of the complaints of the wounded and sick Red Army soldiers are studied, their main problems are highlighted. An attempt was made to determine the degree of reliability of perceptions of hospital life reproduced in complaints. Conclusions. The analysis made it possible to identify a wide range of problems faced by the wounded who were treated in local evacuation hospitals: poor-quality nutrition, low level of material and sanitary support, theft of property, shortcomings in the organization of treatment, violations of military and labor discipline. Conducting a comparative analysis of the information obtained from a significant number of complaints with the data of office documentation allows us to judge a fairly adequate reflection of the extreme everyday life of base hospital in the messages of the wounded.

One of public service offered by Investment and One Stop Integrated Service Office is a service of getting license of housing and residential area. Some complaints and suggestions are delivered to this office for better service. This study is aimed to measure public perception level towards Investment and One Stop Integrated Service Office on solving complaints and suggestion by giving license of housing and residential area. The method used in this study was survey in reference to the Regulation of the Minister of Administrative Reform and Bureaucratic Reform of the Republic of Indonesia Number 14 of 2017 about guidelines for arranging survey of public perception unit.

Background: The Office of the Ombudsman of the Republic of Bulgaria (ORB) is an independent constitutional body elected by Bul­garian Parliament in 2005. It serves to protect the rights of all citizens, including the rights of patients, children, people with disabilities, minorities, foreigners, etc. Bulgarian healthcare users complain when they feel that the healthcare system (HCS) has failed their needs or they have been recipients of an inappropriate treatment.Aim: The aim of the present study was to analyze the structure and dynamics of all complaints from Bulgarian healthcare users referred to the ORB over a 13-year period (2005 – 2018).Materials and methods: Retrospective documental research was used in the present study. The data included the complaints ob­tained from the official annual reports of the ORB that are available online. Bibliographic and documental searches were also used as sources. The complaints were analyzed by their annual distribution and classified by problem areas in the HCS.Results: Between 2005 and 2018, there were a total of 3288 complaints filed to ORB against HCS. In 2015, 368 complaints were re­ceived by ORB from Bulgarian healthcare users and from various patient organizations concerning problems in the HCS. The filed complaints to ORB increased by 82% in 2016 (n=421). In 2017, the overall number of ORB-referred complaints amounted to 494, and in 2018 their number was as high as 607, which represents an increase by 23% compared to the number of complaints in 2017.Conclusion: The great number of complaints referred to ORB about the HCS over the last four years strongly suggests that the institu­tion of the Ombudsman in Bulgaria enjoys high confidence among Bulgarian healthcare users.

The increase of minimum wage in 2018 in Russia turned out to be the most pronounced in regions of the Far North and similar localities due to the exclusion of regional compensation payments and Northern allowances from the minimum wage. We are interested in both studying the effects of the minimum wage’s increase and assessing its value’s compliance. The article suggests a new approach to achieving these objectives based on the number of workers’ complaints to the State Labour Inspectorate. We developed and applied an econometric model to reveal the connection between the rate of compensation payments in a region and the number of complaints regarding the problem that “the employer pays less than the law requires”. As the study’s information base, we used the data gathered from an online dataset of the Federal Service for Labour and Employment, Federal State Statistics Service, and the professional database “Ruslana”. We discovered that in 2018, the number of complaints on the considered topic in the North regions was 2.5 times higher than in other regions. An increase in the value of regional compensation payments is associated with an increase in the number of complaints. The largest number of complaints came from employees of small enterprises, budgetary institutions, and firms experiencing financial difficulties. The legal authorities may use suggested recommendations regarding the legislation of the status of regional compensation payments and Northern allowances in the process of determining the minimum wage. We recommend the employers to use the checklists that allow minimizing the risks of consequences of labour law’s violations in the Far North and similar localities.

Abstract Background Primary rhinoplasty outcomes may not meet individual expectations. Consequently, reoperation may be advocated to improve results. This study examines the prevalence of individuals considering revision rhinoplasty, while identifying the main cosmetic and functional complaints and factors associated. Methodology This is a cross-sectional study conducted in Saudi Arabia using a self-reported online questionnaire distributed through social media channels. The sample included 1370 participants who were all Saudi nationals over the age of 16 who had undergone primary rhinoplasty at least 1 year prior. Results The prevalence of individuals considering revision rhinoplasty was 44.7%. The primary reason for considering it was the desire for further esthetic improvement in an already acceptable result (50.16%). The most common cosmetic complaints subjectively reported were poorly defined nasal tip (32.35%). The most prevalent nasal function symptom was nasal obstruction (56.9%). Significant factors associated with considering revision rhinoplasty included the physician not understanding the patient’s complaints, short consultation time, low monthly income, inadequate information about the expected results, not using computer imaging to predict outcomes, lack of rapport with the surgeon, and inadequate information about the risks and complications. Conclusions A thorough understanding of patient concerns and expectations, as well as thoughtful consideration of risk factors, may help surgeons achieve more successful outcomes and potentially reduce the incidence of revision rhinoplasties. Level of evidence III

The aerial sport has experienced a vast development generated by economic growth, the needs of fast transport, tourism, as well as the involvement of Romania in international freight transport. At the same time, this is added to the specific characteristics of air transport, which, together with the characteristics of other modes of transport, is gaining increasing importance for particular transport objects. Air transport in Romania has reached historic highs in recent years, through the number of domestic and international flights, and the number of passengers exceeded 2 million in 2018.The transport companies that operate in and from Romania aim to attract passengers with increasingly tempting offers and most often at competitive prices with traditional transport. In order to be able to create a strategy that is as competitive as possible for Romanian passengers, the airline companies aim to identify the elements that define the behavior of the Romanian consumers. This article aims to highlight the most important factors that influence the purchase of the air transport service, at the level of Romania, as well as their financial valence.

Introduction. With the increase in cognitive impairment among young people, it is important to timely identify and modify risk factors. The aim of the study was to evaluate early cognitive disorders in relationship with subjective hearing disorders, burnout syndrome, and depression among middle-aged women. Methods. The study involved 310 women aged 26 to 59 years (M=38.6). An online survey was created. Respondents filled in the Cognitive Failures Questionnaire (CFQ), Subjective Cognitive Complaints (SCCs) questionnaire, Shirom-Melamed Burnout Measure (SMBM), and Geriatric Depression Scale (GDS). Sociodemographic factors, addictions, subjectively reported presence of chronic diseases, and subjective hearing disorders were registered by the study questionnaire. Student’s t-test, Chi-square test, Fisher’s exact test, and logistic regression analysis (LRA) were used for data analysis. Results. 34 females (11%) had subjective cognitive failures (CF+ group) and 276 (89%) had not (CF- group). 28.7% of respondents had subjective cognitive complaints (SCC+ group) and 71.3% had not (SCC- group). 23 females (7.4%) had depression and 62 females (20%) were likely to be depressed. 34 (11%) females had significant symptoms of burnout. 30.6% (N=95) self-reported having chronic diseases. 14.84% of females had subjective hearing disorders. The CF+ group had higher GDS scores than the CF- group (M=6.88 vs. M=3.78, p

This study investigates the use of verbally incomplete utterances in French-language complaints about third parties or situations. In these cases, a speaker initiates a turn with verbal means but stops talking before reaching lexico-syntactic completion. The utterance becomes recognizable as an expression of negative stance or as a precise negative assessment by virtue of the linguistic formatting of the turn-initiation, its position within the larger interactional context, and the speaker’s accompanying bodily-visual displays and vocalizations. Data consist of video-recorded coffee-break conversations among first and second language speakers of French. Using multimodal Conversation Analysis, the analysis documents recurrent linguistic formats of the verbally incomplete utterances and examines the interactional deployment of the utterances in two distinct sequential contexts: (1) in the initiation of complaints, and (2) at the end of complaint tellings or reports. In the first of these, the action of leaving a turn verbally incomplete and expressing stance with bodily-visual means allows the speaker to prepare the grounds for the complaint by foreshadowing the negative valence of the upcoming talk. In the latter case, the verbally incomplete utterance and accompanying vocal and/or embodied conduct are deployed as a summary assessment or upshot of the complaint which shows, rather than merely describes, the complaint-worthiness of the situation. In both cases, the utterances work to enhance the chances for the speaker to obtain affiliative responses from coparticipants. While prior studies on verbally incomplete utterances have suggested that such utterances may be specifically suitable for subtly dealing with delicate actions, in this study the utterances are sometimes produced as part of multimodal ‘extreme-case expressions’ that convey negative stance in a high-grade manner. The findings contribute to a better understanding of interactional uses of verbally incomplete utterances and of the multimodal nature of negative assessments. The study thereby furthers our understanding of how grammar and the body interface as resources for the accomplishment of context-specific actions and the organization of social interaction.

Prior to this research, legal practitioners and client advocates in New South Wales were regularly reporting that their disadvantaged or marginalised clients were mistrustful of, and dissatisfied with, the NSW Police complaints system. In an online survey, 239 client advocates described a recent incident in which a client with grounds to lodge a complaint against police declined and provided the reasons for their client’s decision. Qualitative analyses of the narrative responses confirmed the anecdotal evidence, thereby indicating a diminished sense of the legitimacy of the police service. The research findings were then examined against the four principles of procedural justice – trustworthiness, respectful treatment, neutrality and voice – which have been established as critical for securing and maintaining police legitimacy. This allowed conclusions to be drawn about how police might restore community confidence.

The lack of pragmatic competence could result in unexpected effects on the speakers; for example, the speakers are considered as rude and aggressive people. Accordingly, developing pragmatic competence for EFL learners should be a great concern. This article is aimed to fill in the needs of pragmatic teaching by providing examples of teaching practices that could be used to develop EFL learners’ pragmatic competence. There are two tasks that have been designed by drawing on discourse processing framework proposed by Celce-Murcia and Olshtain (2000) to achieve the production of both written and spoken discourses. The first task is on speaking, particularly on the speech act of oral complaints. The second task is on writing a letter of complaint. This article suggests that developing pragmatic awareness through the speech act of oral and written complaints is desirable.