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Sparse professional literature on complaints against social workers, focuses on a few specific variables, discussing them from a universal/contextless viewpoint. This study considers such complaints as a holistic (integrative) issue which should be studied within particular contexts. The research traced service users' complaints against social workers, investigating social workers' conceptions concerning the extent and type of complaints, and the social workers' coping mechanisms. A phenomenological approach elicited data from semi-structured in-depth interviews with 16 social workers from Arab welfare bureaus in Israel. Findings indicated that formal complaints are rare despite many grievances (tazamur) concerning the service. There are almost no complaints concerning serious offences, because in addition to formal punishment, community cultural punishments are severe. Complaints can be lodged in eight regulatory bodies, inside or outside the bureau, distinguished as either educational or disciplinary in policy. Coping strategies (expressing internal or external loci of control) depend on the complaint type (against the system or against the social workers' professional functioning and/or ethical behaviour) and the regulatory body's character. A professional-ethical complaint is a context-informed pragmatic challenge that social workers should understand and be trained to consider as an opportunity for professional development. [ABSTRACT FROM AUTHOR]

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 Methods: A systematic literature review of UK published and unpublished (so-called grey literature) studies was conducted (PROSPERO registration: CRD42022301980).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 FROM AUTHOR]

Accounts of police complainants and their experiences of oversight largely reflect North American data. This article examines how complainants fare in Ireland, where police crisis and reform have repeatedly occurred since 2005. Quantitative analysis of the independent police oversight agency's complaint processing highlights patterns in allegations submitted, complaint-handling mechanism applied, and outcomes realised. In doing so, this article draws attention to the experiences of Irish Travellers, the homeless and prisoners. Findings show that socially marginal complainants submitted more serious allegations, secured higher investigation designations but were less likely to have complaints substantiated. Overall, substantiation was below international levels and police investigations were more likely to substantiate complaints than was the oversight agency. Consequently, the article then considers the frequent theoretical characterisation of police oversight in term of 'justice' or 'agency', arguing for inclusion of 'agency self-interest' by the oversight body in future research. [ABSTRACT FROM AUTHOR]

Substantiated incidents of poor welfare affecting cattle, sheep and goats (livestock) in non‐dairy extensive farming systems continue to occur. This study sought to describe the common causes of poor welfare of livestock and the associated circumstances, by analysing 39 years of de‐identified, livestock welfare investigation records. There were a total of 2179 alleged offenders (AOff), defined as individual/s that had an incident of poor welfare affecting livestock on at least one occasion. Approximately 27% of AOff were found to have poor welfare on more than one occasion. The majority of livestock welfare incidents were associated with neglect, more specifically, inadequate nutrition (56%), treatment (65%) and management/husbandry (83%). Records of malicious acts were rare (1%). In the analysis, cases were allocated to 10 animal welfare severity categories (AWSC) based on the number of incidents and visits, whether the AOff reoffended, or if the incident was ongoing and whether the welfare issue was likely to affect the whole herd. A significantly higher proportion of cases in the most severe AWSC had a failure to shear, mark, dip/drench, draft and wean/cull, were overstocked or were not providing proper and sufficient feed, compared to the least severe AWSC (P ≤ 0.05). Reoffending was significantly more likely when animals were found to be injured/unwell, recumbent, stuck in mud/yard/pen or in poor body condition, or when there was a failure to wean/cull, mark, dip/drench and draft. Some of the issues identified here may be risk factors more commonly identified on farms with poor livestock welfare. [ABSTRACT FROM AUTHOR]

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.

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 FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. Key Points: The prevalence of health problems is high: Almost all professional ballet dancers (97%) reported at least one injury, 65% an illness and 28% a mental health problem during one season. Health problems have substantial impact: On at least 29% of the days documented in the weekly reports, the dancers were not able to dance at full potential due to a health problem. Many injuries seem to be preventable: Half of the injuries occur during training (26%) or rehearsal run-through (23%) and the most frequent reasons were "too much workload" (35%), "tiredness / exhaustion" (n=22%) and "stress / overload / insufficient regeneration" (22%). [ABSTRACT FROM AUTHOR]

Social workers' professional failures are considered inevitable occurrences. However, virtually all research on professional failure management relates to the healthcare field. The scant literature on professional failure does not give much weight to the profound implications of context on professional functioning. This pioneer study illustrates how important it is to consider the context to understand the daily workplace occurrence of social workers' professional failures. The research traced social workers' professional failures as perceived by welfare bureaus managers. A phenomenological approach elicited data from semi-structured in-depth interviews with twenty Arab welfare bureaus managers in Israel. Findings indicated that the managers encountered a lot of 'minor' individual and collective failures in different dimensions, and understood failure as a transient episode, mostly trivial and understandable. The main criterion for failure was damage attributed to a particular intervention. Responsibility for failure was not usually seen as stemming from the social workers' faulty professional-ethical considerations, rather it was attributed to factors associated with the establishment: lack of appropriate resources and non-culture-sensitive policies. Managers coped creatively with what they defined as failures, preserving their profession's inalienable assets with a 'non-confrontational' policy while ensuring individual learning from the failure, to prevent future repetition. [ABSTRACT FROM AUTHOR]

In 1986, the World Health Organization heralded Singapore as a model for the control of dengue fever, a viral disease spread by the Aedes aegypti mosquito. Between 1965 and 1985, public health officials successfully employed educational campaigns and mandatory home inspections to convince citizens to guard against mosquito breeding at home. Although this story appears to recapitulate standard narratives of top-down progress in Singapore, this paper argues that the significant role of the public in public health has been overlooked. Citizens complained frequently, sometimes publicly, to public health authorities and often compelled direct responses from them. Through these complaints, citizens modified official anti-mosquito measures and expanded the reach of public health. Public health in Singapore thus appears not simply as the imposition of an autonomous state's vision onto a docile or even resistant citizenry but as a coevolution of the state and the public. [ABSTRACT FROM AUTHOR]

HELL Pizza's advertising is characterized by its provocative art, audacious copy and bold tactics that relishes in its hellish reputation. Rather than merely relying on attention-grabbing stunts, the brand employs strategies that tap into the deep-seated cultural norms of its audience. Often deemed controversial, HELL's advertising elicits strong public reactions, serving as a mirror reflecting the evolving cultural and moral sensitivities and the place of Christianity in Aotearoa New Zealand. This article critically examines the official complaints about the use of religious references in HELL's advertising to the Advertising Standards Authority (ASA) in Aotearoa New Zealand. Using thematic analysis, we analyse how 'offense' and references to Christianity are navigated by the public complainant, the ASA and the brand, in 79 rulings between 2005 and 2021. We conclude that while the brand consistently negotiates a fine line between edgy humour and potential offense, the ASA rulings suggest a societal trend leaning towards freedom of artistic expression, even when intertwined with religious undertones, particularly when a brand has a well-established identity. [ABSTRACT FROM AUTHOR]

Recent reports have highlighted the discriminatory treatment endured by foreign national prisoners (FNPs) in particular Irish prisons, but one key voice has been relatively absent from the discourse to date – the perspectives of the prisoners themselves. This article aims to complement these "top-down" perspectives with a comprehensive "bottom-up" analysis rooted in the experiences of 82 FNPs and explore the extent to which they were subject to racism, discrimination and differential treatment by prison staff and fellow inmates across eight Irish prisons. The article begins by outlining the methodology of the qualitative study. It then presents our findings in two parts. The first part focuses on FNPs' personal views of their relationships with staff in Irish prisons. The second part explores the extent to which these FNPs interact with Irish prisoners and prisoners from other jurisdictions. The article reveals that forming relationships with staff and fellow inmates is challenging for certain FNPs due to racial prejudice, language barriers and segregation based on nationality. [ABSTRACT FROM AUTHOR]

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

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. [ABSTRACT FROM AUTHOR]

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 FROM AUTHOR]

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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 FROM AUTHOR]

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. DsmAL-oYwbuhyB_vVwEdDj Video Abstract [ABSTRACT FROM AUTHOR]

Background & Objective: COVID-19 forced us to develop adaptive ways to the new normal of healthcare delivery. Neurology has one of the most diverse types of patients who require urgent, prolonged and multidisciplinary care. This study aimed to understand the impact of the unprecedented community lockdown among patients with chronic and new onset neurologic conditions on emergency room (ER) utilization in a single tertiary hospital in Makati City, Philippine. Methods: We retrospectively examined all consecutive neurology referrals made at the ER from March to August 2020 and compared them with a control group consisting of all ER neurology referrals during the same months in 2019. Results: There was a 45% decline in the volume of referral to neurology service at the ER during the first 6 months of the lockdown period. There were fewer females who sought emergency neurologic care (p=0.019). The average age of patients increased from 55.5 years (σ=19.9) in 2019 to 59.5 years (σ=18.4) in 2020 (p<0.001). The top three chief neurologic complaints in 2019 were dizziness (17.7%), motor weakness (14.1%), and headache (13.2%). In 2020, the top three neurologic complaints where motor weakness (19.0%), decreased level of consciousness or loss of consciousness (13.2%), and dizziness (11.2%), (p<0.001). The average time from symptom onset to ER admission in 2019 was 5.1 days (σ=23.9) which increased to 8.4 days in 2020(σ=28.1), (p<0.001). The proportion of patients with no co-morbidities at the ER decreased from 27.6% in 2019 to 17.0% in 2020 (p<0.001). Patients with pre-existing cardiovascular diseases, endocrine diseases, pulmonary diseases, renal diseases, cancers, and others have significantly increased (p<0.05). However, the increase in the proportion of patients with pre-existing neurological disorders (p=0.143) was not statistically significant (p>0.05). The only pre-existing neurologic conditions with significantly increased in proportion was stroke (p=0.010). Among new onset neurologic diagnoses, headache and facial pain (p<0.001) and peripheral and other neuropathies (p=0.005) significantly decreased in proportions while proportions of cases with new stroke or vascular pathology (p<0.001) and encephalopathy (p=0.003) have significantly increased. ER dispositions showed a significant (p<0.001) decrease in proportions of patients who were admitted, discharged, and transferred to hospital of choice; while patients who were discharged against medical advice and who died at the ER have significantly increased. Conclusion: The initial six months of community lockdown during COVID-19 pandemic caused a significant change in the characteristics of patients referred to neurology for emergency care. These changes provide us a new perspective on how to better deliver optimal neurologic care to these diverse patients especially during times of pandemic. [ABSTRACT FROM AUTHOR]

Whole-Body electromyostimulation (WB-EMS) is a time-effective, joint-friendly and consistently supervised exercise training technology particularly attractive to address health-related outcomes in middle-age to older adults. The present systematic review aims to summarize WB-EMS effects on musculoskeletal diseases and conditions in corresponding non-athletic cohorts. A systematic search in five electronic databases, two study registers and a hand search in Google Scholar without language restrictions up to March 2023 was conducted. We included only peer reviewed clinical trials and intervention studies on WB-EMS with non-athletic adult cohorts averaging 45 years and older addressing musculoskeletal diseases and conditions. Case reports, review articles, editorials, conference abstracts, or theses were not considered. Nineteen research projects with 22 articles focusing on the effect of WB-EMS on musculoskeletal diseases and conditions were identified. In summary high evidence for positive effects were reported for non-specific chronic low back pain and sarcopenia. Moderate evidence was provided for positive effects on knee osteoarthritis and non-significant positive effects on osteopenia. While two out of eight studies reported minor increases of biomarkers related to rhabdomyolysis, one study reported a single case of mild rhabdomyolysis after a WB-EMS session. No study reported clinically relevant adverse effects. In summary, we have provided further evidence for predominately positive effects of WB-EMS on musculoskeletal diseases and conditions along with a lack of clinically relevant adverse effects related to WB-EMS application in middle-aged and older cohorts. [ABSTRACT FROM AUTHOR]

Objectives: Nursing home (NH) residents' capacity to communicate deteriorates with dementia. Consequently, NHs with high proportions of people living with dementia (PLWD) may receive fewer resident complaints, and/or investigating complaints may be challenging. We assessed NHs' proportion of PLWD in relation to total and substantiated complaints. Methods: Data were from the ASPEN Complaints/Incident Tracking System and the Certification and Survey Provider Enhanced Reports (2017). NHs (N = 15,499) were categorized based on high (top-10%), medium (middle-80%), and low (bottom-10%) dementia prevalence. Negative binomial Poisson regression assessed complaint patterns in relation to NHs' high/low (vs. medium) proportions of PLWD and other facility/resident characteristics. Results: Compared to NHs with medium-dementia prevalence, NHs with low proportions of PLWD had higher total (average marginal effect [AME] = 0.16, p < 0.001) and substantiated (AME = 0.30, p < 0.001) complaints, whereas NHs with high proportions of PLWD had fewer total (AME= −0.07; p < 0.05) and substantiated (AME= −0.11, p < 0.05) complaints. Also, NHs' profit status, chain-affiliation, size, staffing, and resident ethnicity were associated with total and substantiated complaints. Conclusion: The association between high proportions of PLWD and lower NH complaints suggests either that these NHs have higher overall quality or that complaints are underreported. Regardless, surveyors and families may need more involvement in monitoring higher dementia prevalence facilities. [ABSTRACT FROM AUTHOR]

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.

Background: Subjective everyday hindrances associated with low-frequency noise (LFN) can be high; however, there is still a lot unknown about experienced complaints. This study aims to investigate (1) subjective complaints and (2) coping strategies of individuals reporting everyday hindrances from LFN. Methods: Cognition, depressive symptoms, sleeping, fatigue, stress, and coping questionnaires were administered to participants sampled for their LFN complaints (LFN1 = 181), LFN complainants derived from a community sample (LFN2 = 239), and a comparison group without LFN complaints (CG = 410). Results: Individuals reporting LFN perceptions reported complaints in all domains and showed a higher proportion of above average symptom severity compared to the CG. Most complaints were reported by the LFN1 group, the least by the CG. However, on some sleeping, fatigue, and stress-related variables, a similar or even higher symptom severity was observed in the LFN2 group. Further, all groups used a similar combination of multiple coping strategies, although the LFN1 group scored higher on support seeking. Conclusions: There might be differences in the complaint severity between different LFN subgroups and future investigations of primary and secondary complaints are necessary. Also, more research about the use and success of coping strategies for LFN-related hindrances are needed for clear conclusions. [ABSTRACT FROM AUTHOR]

This paper investigates the relationship between extreme temperature and online complaints to local government officials. We show that the number of complaints significantly increases by 11.1% on extremely hot days relative to the benchmark temperature. Such effect is most pronounced on the day of extreme weather conditions and muted immediately after the extreme weather day. Among all the complaint areas, we find that 28.6% of the increase in complaints on hot days is related to public service, 42.8% to urban construction, 21.4% to noise, and 7.2% to safety. Moreover, we reveal that the primary motivators of increased complaints on hot days are not likely to be psychological factors; instead, the complaints are more likely to be associated with inadequate provision of public facilities to cope with extreme weather and inadequate management of other environmental disamenities caused by extreme temperature. [ABSTRACT FROM AUTHOR]

Nursing homes receive complaints when actual care provided to residents misaligns with desired care, suggesting that person-centered care (PCC) and honoring resident preferences in care delivery may help prevent complaints from arising. We explore whether nursing home implementation of a PCC tool, the Preferences for Everyday Living Inventory (PELI), is related to measures of complaints. Publicly available data on Ohio nursing homes was used to examine 1,339 nursing home-year observations. Regression techniques were used to evaluate the relationship between the extent of PELI implementation and four complaint outcomes: any complaint, number of complaints, any substantiated complaint, and number of substantiated complaints. Nursing homes with complete PELI implementation were less likely to have any complaints by 4.7% points (P <.05) and any substantiated complaints by 11.5% points (P <.001) as compared to partial PELI implementers. When complete PELI implementers did have complaints, they were fewer than partial PELI implementers. Complete PELI implementers were not immune from receiving complaints; however, the complaints they did receive were fewer in number and less likely to be substantiated as compared to communities who only partially implemented a PCC tool. [ABSTRACT FROM AUTHOR]

Identifying the risk and predicting complaints and misconduct against health practitioners are essential for healthcare regulators to implement early interventions and develop long-term prevention strategies to improve professional practice and enhance patient safety. This scoping review aims to map out existing literature on the risk identification and prediction of complaints and misconduct against health practitioners. This scoping review followed Arksey and O'Malley's five-stage methodological framework. A comprehensive literature search was conducted on MEDLINE, EMBASE, and CINAHL databases and finished on the same day (6 September 2021). Articles meeting the eligibility criteria were charted and descriptively analysed through a narrative analysis method. The initial search generated 5473 articles. After the identification, screening, and inclusion process, 81 eligible studies were included for data charting. Three key themes were reported: methods used for identifying risk factors and predictors of the complaints and misconduct, synthesis of identified risk factors and predictors in eligible studies, and predictive tools developed for complaints and misconduct against health practitioners. The findings reveal that risk identification and prediction of complaints and misconduct are complex issues influenced by multiple factors, exhibiting non-linear patterns and being context specific. Further efforts are needed to understand the characteristics and interactions of risk factors, develop systematic risk prediction tools, and facilitate the application in the regulatory environment. [ABSTRACT FROM AUTHOR]

Mandatory reporting of elder abuse aims to detect and prevent mistreatment and improve services. Service users and their relatives can raise concerns, but only staff can file mandatory reports. This article examines how the concerns of service users and relatives were managed by designated officials in reports of mistreatments in care for older adults in Sweden. We lean on sociological theories of "interpersonal trouble" and organizational "disputes domains." The thematic analysis is based on 28 incident reports initiated by service users or their relatives. The analysis shows that the reports were managed in one of three ways: asymmetrically, by 1) dismissing or 2) supporting the complainant's position, or symmetrically, by 3) treating complainants' accounts as credible but minimizing their seriousness. There were differences between reports initiated by service users and relatives. Dismissing concerns about abuse, mainly those made by relatives, risks support for service users failing. [ABSTRACT FROM AUTHOR]

Complaints to third-party entities like government agencies reflect a high level of customer dissatisfaction. Such complaints in the airline industry typically reflect a failure to redress first-stage complaints and often attract negative publicity. This paper examined the relationship between passenger complaints filed with the U.S. Department of Transportation (DOT) and airline quality from 2006-2019 for leading legacy network carriers and low-cost carriers. Operational performance data (punctuality, oversales, and mishandled baggage) and complaints reported to DOT were used as proxy for airline quality. Regression analysis showed punctuality had a negative effect and oversales had a positive effect on rate of complaints for both types of carriers. Mishandled baggage had no effect on complaint rate for discount carriers and negative effect on complaint rate. Implications of these results are discussed. [ABSTRACT FROM AUTHOR]

The Independent Press Standards Organisation is the largest press regulator in the UK chosen by the majority of national and regional publishers to protect standards. Ipso was established in controversial circumstances following the 2011 Leveson Inquiry into press practices and ethics after the tabloid phone hacking scandal. The Press Complaints Commission, which preceded Ipso, was disbanded having received considerable criticism at the inquiry for its limited regulation of the press. The Leveson report recommended a new system that included legislative backing through a Press Recognition Panel to guarantee independent press regulation, a proposal accepted by parliament. Ipso was set up by publishers without this recognition and to a background of publisher hostility to the Leveson report. Ipso, in its corporate strategy, says it does protect the public and freedom of expression. This paper attempts to examine that claim by looking in detail at the complaints made to Ipso and the resulting action to see if it really does protect the public in the way Leveson called for and parliament supported. [ABSTRACT FROM AUTHOR]