Objectives To survey complainants' experience and the outcome of lodging a complaint about medical treatment. Design and setting Random sample survey. A 32‐item questionnaire was sent to 500 complainants by the New South Wales Health Care Complaints Commission (HCCC), and responses were returned reply‐paid to the university. Participants 290 people with complaints finalised by the HCCC between February 1996 and August 1997. Outcome measures Profile of complainants and doctor involved; type and place of Incident; complainants' emotions at the time of the incident and at the conclusion of the complaints process; outcome of complaint, and satisfaction with outcome and Intention to take further action. Results After excluding non‐medical complaints, 290 of 314 questionnaires returned were analysed, giving a response rate of 63% (314/500) : 64% of complaints were about clinical care, and the remainder related to rudeness or poor communication (22%), and unethical or Improper behaviour (14%); 70% of complainants were women, and 44% of complaints were on behalf of another person; Complainants had a high socioeconomic status, and 60% were currently in paid employment; More than half the incidents occurred in doctors' consulting rooms; 87% of the doctors Involved were men, and over half were general practitioners. 37% of complaints were dismissed; 21% of complainants did not know the outcome of their complaint, and 40% believed that the doctor had been disciplined. Most complainants were dissatisfied with the outcome; a quarter stated that they would sue, but 70% would do nothing further. All but two complainants would never consult the doctor involved again. Conclusions Most of the respondents were not satisfied with either the process or the outcome. Typically they wanted stronger measures taken. Only a few wanted compensation; more wanted acknowledgement of harm done; and most wanted the doctor punished.

Abstract

This study examines the perspective of judges regarding child custody evaluations by mental health professionals. Ninety-seven judges completed an anonymous survey regarding: a) legal standards and personal biases influencing judicial custody decision-making; b) issues that prompt judges to order custody evaluations; c) expected evaluation procedures and report components; d) parts of the report judges find useful for decision-making; and e) the effect of the evaluation on litigation and judicial decision-making. Findings indicate that judges are most likely to order custody evaluations for allegations regarding sexual or physical abuse or parental unfitness. Judges reported that they expect a comprehensive procedure and find utility in an inclusive report. Survey findings suggest that custody evaluations play a significant role in judicial decision-making; however, judges are hesitant to have mental health professionals testify as to the ultimate custody question.

This study examined levels of AIDS knowledge and condom practices in a sample of female commercial sex workers (CSWs) in Bangladesh. The 284 subjects were questioned about AIDS knowledge using a 12-item AIDS knowledge and patterns of condom use questionnaire. The subjects had a moderate knowledge of AIDS with 61.5 percent of the sample responding correctly to 6 or more of the 12 AIDS knowledge questions. Those with high levels of AIDS knowledge used condoms at a higher rate than those with low levels of AIDS knowledge. These CSWs were predominantly young (36.6 percent) and illiterate (62.7 percent). Street-based CSWs were at greatest risk for acquiring HIV; many reported less frequent use of condom than brothel-based CSWs. The majority knew that condoms offered protection against HIV/AIDS, although only 11 percent reported using condoms prior to the day of survey. Misconception and confusion were identified regarding modes of transmission and prevention.

Background A method has been developed and validated for selective, accurate and precise determination of total proteinogenic amino acids and taurine from Infant Formula and Adult/Pediatric Nutritional Formulas (powders, ready-to-feed liquids, and liquid concentrates). The method was reviewed by the AOAC INTERNATIONAL SPIFAN Expert Review Panel (ERP) during the 133rd AOAC Annual Meeting & Expo on September 7, 2019 in Denver, CO, USA and was recommended to First Action Official MethodsSM status. Objective The method involves protein hydrolysis to amino acids, a simple pre-column derivatisation of amino acids and separation of derivatised amino acids by UHPLC. The quantification of amino acids is performed by multi-point calibration using norvaline as the internal standard. The analytical method is capable of quantitative determination for 22 proteinogenic amino acids, but cannot be used to quantitate tryptophan, which is destroyed during the acid hydrolysis step. Asparagine is determined as aspartic acid and glutamine as glutamic acid. The cystine and cysteine are converted to S-2-carboxyethylthiocysteine (CYSx) and the derivative is separated from the other amino acids. Citrulline which is present in some matrices and it is separated from other amino acids is not included in the method performance evaluation in the single laboratory validation (SLV). Method The proposed method met all the performance requirement limits set in standard method performance requirements (SMPR) 2014.013 for total proteinogenic amino acids and taurine. The correlation coefficient of multi-point calibration was not less than 0.999 for any amino acids at any point in the SLV study confirming the validity of linear dynanic range (LDR) and linearity of the method. The individual amino acids in the chromatogram were identified by absolute retention time and relative retention time (RRT) with respect to the internal standard norvaline. There were no significant (S/N Ratio <10) interferences from the reagents or by-products of derivatisation and targeted matrices. The method demonstrated high selectivity. Result Accuracy of the method was validated using standard reference materials (NIST SRM 1869 and 1849a) and spike recovery studies. The amino acid results in the SRMs were within the ranges of Reference Mass Fraction Values. The accuracy of the method was corroboratively validated by spike recovery studies. The average spike recovery range between 93 to 107% ensure the accuracy of the method for amino acids and compliance to the AOAC SMPR 2014.013. Conclusions Precision data of the method demonstrate that it meets the stakeholder requirements as per the SMPR. The mean RSDr for all the amino acids for 17 matrices selected for the SLV were not more than 4%. The method is very sensitive and the LOQ can go down to approximately ten times lower than the SMPR requirements. The sensitivity of method is a direct reflection of its signal to noise ratio which ensures guaranteed method performance at the lower levels of amino acids in these matrices. Highlights Taurine (aminoethane sulfonic acid) unlike the other amino acids is a beta-sulfonic amino acid that is not used in protein synthesis but is found as a free amino acid in tissues. The acidic functional group (-COOH) in common amino acid is replaced with a sulfonic acid (-SO3H) group in Taurine. The method offers baseline separation of citrulline which is an alpha amino acid generally present in Infant Formula and Adult/Pediatric Nutritional products. The separation of citrulline eliminates the risk of interference of this compound with other amino acids. The method can also separate and quantitate hydroxyproline, an important component of collagen that is often used to quantitate collagen. The method is simple and does not include any proprietary chemicals or instruments and can be performed on any basic reverse phase UHPLC system with UV detection.