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Background: Cluttering is a fluency disorder characterized by an abnormally fast or irregular speech delivery rate along with disfluencies that are frequent but are not judged to be stuttering. Data on cluttering prevalence in the general population are scarce, as well as its association with psychological well‐being indices, such as anxiety, and depressive symptoms. Aims: To estimate cluttering prevalence among undergraduates, as well as its relationship with psychological and well‐being indicators. Methods & Procedures: To address these issues, a large sample (n = 1582) of undergraduates completed a questionnaire that provided a lay definition of cluttering and were asked to identify themselves as clutterers (SI‐Clut), as well as to indicate the presence of several psychological and mental well‐being indices. Outcomes & Results: A total of 276 respondents (23%) self‐identified as clutterers (now or in the past), with 55.1% of those being male. Only 56 respondents (3.5% of the total sample; about 21% of SI‐Clut) reported having received speech therapy for cluttering. Relative to students self‐identifying as non‐clutterers, self‐identification of cluttering was associated with higher levels of psychosomatic symptoms, depressive symptoms and stress, indicating a tendency toward internalizing psychopathology, along with lower self‐esteem, and lower subjective happiness. Conclusions & Implications: The current findings point to the high prevalence of students self‐identifying as clutterers, along with a significant link between cluttering and mental distress. Therefore, it is important to increase public awareness of cluttering, its diagnosis and treatment. From the clinical perspective, the elevated levels of somatic complaints, anxiety and depression may represent internalizing psychopathology, associated with more covert rather than overt symptomatology. Such symptom manifestation calls for special attention from the speech–language pathologists providing cluttering therapy, using designated well‐being or mental health screening tools. Although data on standard cluttering treatment are limited, it should be customized to the client's unique difficulties. Speech–language pathologists' understanding of cluttering, which includes both speech characteristics as well as psychological and social aspects of well‐being, may assist them in implementing effective treatments. WHAT THIS PAPER ADDS: What is already known on the subject: Cluttering is a fluency disorder characterized by an abnormally fast or irregular speech rate, along with various disfluencies and articulatory imprecision. It may co‐occur with other disorders, such as learning disabilities, and attention‐deficit/hyperactivity disorder. Data on cluttering prevalence and its association with psychological well‐being indices, such as anxiety and depression, are limited. What this paper adds to existing knowledge: A total of 276 undergraduates (23%) self‐identified as clutterers, of whom 55.1% were males. A total of 56 respondents (3.5% of the total sample, and about 21% of undergraduates self‐identified as clutterers) reported having received speech therapy for cluttering. Psychosomatic symptoms, depressive symptoms and stress levels were higher among these students, suggesting a tendency toward internalizing psychopathology, along with a lower sense of self‐esteem and subjective happiness. What are the potential or actual clinical implications of this work?: The high prevalence of students self‐identifying as clutterers, along with the low percentage of respondents who received speech therapy for cluttering, emphasize the need to raise public awareness of the problem, its diagnosis and treatment (Reichel et al., 2010). The association between cluttering and mental distress requires speech–language pathologists to be aware that cluttering may have covert symptomatology, similar to stuttering, which should be addressed in therapy. [ABSTRACT FROM AUTHOR]

Introduction: Academic distress has been frequently reported following the COVID-19 pandemic. This study estimates academic distress among undergraduate students, characterizes its nature in relation to economic, social, and health indicators, and examines the level of request for help following mental distress. Students with higher levels of academic distress were expected to show lower socio-economic status, lower social connections, and lower wellbeing indices. Methods: A cross-sectional study based on a structured anonymous questionnaire was delivered online to more than 1,400 undergraduate students from one university in Israel (women, 66.7%). Results: Academic distress was reported by 27.1% of the sample. Students who reported academic distress were more likely to report stress, negative psychosomatic symptoms, changes in weight since COVID-19, low self-esteem, depressive symptoms, higher COVID-19 concerns, and higher security situation concerns. A hierarchic logistic regression model showed that the probability of reporting academic distress was 2.567 times higher (p < 0.001 95% CI [1.702, 3.871]) for those who reported lower family economic status before COVID-19 and 2.141 times higher (p = 0.004 95% CI [1.284, 3.572]) for those who highly reported depressive symptoms. In contrast, only 15.6% of those who reported academic distress sought help from academic authorities. Discussion: The significant associations of academic distress with health indices indicate that the self-reported distress was real and highly related to adverse health measures. A comprehensive, collaborative model that integrates psychological, economic, and social aspects of intervention is required in times of crisis within academic institutions. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has led to the isolation of the population in Israel, including the elderly. The present study aimed to compare the consumption of medical services among adults over the age of 65 in Israel at the time of the first COVID-19 lockdown relative to the corresponding period the year before. Methods: We conducted a retrospective longitudinal observational quantitative research based on the Natali Healthcare Solutions Israel database of subscribers. Company subscribers over the age of 65 (N = 103,955) were included in the sample (64.5% women) in two time periods, before the COVID-19 outbreak-P1, in 2019, and during the first COVID-19 lockdown- P2 in 2020. Logistic regression was applied to examine service consumption for study variables. Results: The average number of referrals to services was lower during the COVID-19 lockdown period (M = 0.3658, SD = 0.781) compared to the corresponding period in the previous year (M = 0.5402, SD = 0.935). The average number of ambulance orders, doctor home visits and service refusals were higher when compared to the same period in the previous year. During both time periods, women (P1- M = 0.5631, SD = 0.951; P2- M = 0.3846, SD = 0.800) required significantly more (p <.000) services than men (P1- M = 0.5114, SD = 0.910; P2- M = 0.3417, SD = 0.753). Older, widowed people, living in non-Jewish/mixed localities, or in average or below average socioeconomic status localities required relatively more services to those with opposite socio-demographic traits (p <.000). Summary and conclusions: In a large sample of elderly in Israel, findings indicate a decrease in referrals to medical care during the first COVID-19 lockdown period, yet an increase in ambulance orders, doctor visits and service refusals. Socio-demographic characteristics showed a similar effect in both time periods. The period of the first COVID-19 lockdown was characterized by a higher incidence of medical service refusals as compared to the equivalent period in the previous year. [ABSTRACT FROM AUTHOR]

This study examined social characteristics and their relations to healthcare service demand among older adults during the first COVID-19 lockdown in 2020. The sample was based on a cohort of 103,955 adults over the age of 65. A general index of needs was composed based on healthcare service use data and was predicted in a multi-nominal logistic regression. The frequency of the total needs significantly (p < 0.000) declined while supportive community services (4.9%, 2.0%), living in a community framework (27.0%, 15.2%), and living in a private residence (29.7%, 20.1%) were significantly associated (p < 0.000) with less frequent needs compared to the complementary groups. Supportive communities turned out to be an extremely important service for older adults. Policy makers should consider expanding supportive community services for older adults, as it was shown to have a positive correlation with lower healthcare service use, which might be an indicator of better overall health. [ABSTRACT FROM AUTHOR]

Immigrants and second‐generation immigrants from Ethiopia in Israel are assumed to be more vulnerable to problematic risk behaviours than host culture population. The aim of this study was to assess risk and protective factors associated with multiproblem behaviours such as committing driving violations, alcohol use, drugs use and violence among Ethiopian young adult immigrants and second‐generation immigrants in Israel. This is a cross‐sectional study, based on a self‐reported anonymous structured questionnaire distributed to 383 Ethiopian emerging adults (mean age 25.3; SD = 3.27, 59.3% female). Multiple Problem Behavior Index (MPBI) was created from their responses to 21 risk behaviour variables including driving violations, alcohol use, Marijuana use and violence. Logistic regression to predict multiproblem behaviours was used. We found that unplanned leisure activity hours during weekends (adjusted odds ratio – AOR = 2.594, p <.01, 95% CI 1.332–5.052), excitement seeking (AOR = 2.122, p<.01, 95% CI 1.257–3.582), depression symptoms (AOR = 2.521, p <.01, 95% CI 1.491–4.261) and gender (AOR = 0.277, p <.001, 95% CI 0.164–0.469) were associated with MPBI. In contrast, racism, perceived discrimination, Israeli and Ethiopian identities were not significantly associated with MPBI after adjusting for gender and family status. These results suggest that in a minority of Ethiopian emerging adult immigrants similar to host culture populations, risk factors such as unplanned leisure activities, excitement seeking and depression symptoms are stronger and significant factors associated with multiproblem behaviours rather than racism, perceived discrimination or Israeli and Ethiopian identities. Resources should be allocated to produce appropriate intervention programs with planned content for leisure time, especially on weekends. [ABSTRACT FROM AUTHOR]

Introduction: We examined how community type, residence attachment, and religiosity contribute to resilience to depressive symptoms, psychosomatic complaints, residential stress, and avoidance behavior among students exposed to terror. Methods: Undergraduate students from Ariel University (N = 1,413; 62.7% females; M age = 26.5; SD = 6.03) completed a self-report questionnaire on socio-demographics, terror exposure, place attachment, and depressive/psychosomatic symptoms. Participants were divided into three residential groups: "Ariel," "Small settlement communities in Judea and Samaria" or "Other places in Israel." Results: Participants from small settlement communities in Judea and Samaria showed significantly fewer depressive symptoms and greater adjustment– less avoidance, psychosomatic symptoms, and residential stress– compared to those living in Ariel or other places in Israel, despite significantly higher exposure to terror. Conclusion: Greater religiosity and residence attachment may protect against depressive symptom development following terror exposure. Secular, temporary residents living in highly terror-exposed areas should be targeted for community strengthening interventions. [ABSTRACT FROM AUTHOR]

Introduction: Body-art, including tattoos and piercings, is steadily increasing world-wide but with relatively limited reporting of adverse outcomes. The objective of the present study was to identify correlates that would facilitate a preventative strategy to minimize adverse effects of body-art. Methods: We examined patterns of body-art, health risk and perceptions among 921 participants (54% female, mean age of 35; SD = 10.8) through in-person questionnaire. Results: A significantly lower frequency of those with body-art acknowledged that not all venues (parlors, clinics, etc.) are safe in terms of health and hygiene (84.7%t vs. 96.6%, p <.001) as compared to those without body-art. Similarly, knowledge of the need for a Ministry of Health certification was reported with lower frequency (77.2% vs. 94.5%, p <.001) among those with body-art. Those who experienced medical complications reported higher frequencies of smoking cigarettes and hookah as well as using ecstasy (MDMA). The risk of medical complication after body-art was 4 times higher in those who used ecstasy (OR = 3.97; CI 1.0–14.4; p < 0.05). In addition, it was more than 3 times higher for street or home tattooing as compared to studio or a licensed medical center (OR = 3.59; CI 1.32–9.76; p <.01), as well as almost 3 times higher among those who did not receive information before performing body-art (OR = 2.70; CI 1.05–6.92; p <.05) and who had somebody other than themselves decide on the body-art design (OR = 2.68; CI 1.00–7.19; p <.05). Conclusions: A targeted informational-preventative program should be developed, informed by the risks highlighted in this study. In addition, it would be necessary to draft policies related to regulation and enforcement in order to more effectively manage body-art service provision. The Ministry of Health should supervise and guide tattooists and practitioners regarding the health risks of body-art and offer training and raise awareness among potential clients. [ABSTRACT FROM AUTHOR]

The purpose of the study was to assess Israeli parents’ knowledge of and attitudes towards practices promoting infants’ safe sleep and their compliance with such practices. Researchers visited the homes of 335 parents in 59 different residential locations in Israel and collected their responses to structured questionnaires. SPSS 25 statistical package for data analysis was used. Attitude scales were created after the reliability tests and scaled means of parental attitudes were compared between independent groups differentiated by gender, ethnicity, and parental experience. A logistic regression was run to predict the outcome variable of babies’ sleep positions. The total knowledge score was significantly higher for women (56.3%) than for men (28.6%; p < 0.001). Arabs were more committed to following recommendations (29.3%) than Jews (26.9%; p < 0.001). Consistent with safe sleep recommendations, 92% of the sampled parents reported avoiding bedsharing and 89% reported using a firm mattress and fitted sheets. The risk of not placing a baby to sleep in a supine position was higher among older parents (adjusted odds ratio—AOR = 0.36, 95%CI 0.16–0.82), smoking fathers (AOR = 2.66, 95%CI 1.12–6.33), parents who did not trust recommendations (AOR = 4.03, 95%CI 1.84–8.84), parents not committed to following recommendations (AOR = 2.83, 95%CI 1.21–6.60), and parents whose baby slept in their room (AOR = 0.38, 95%CI 0.17–0.88). Knowledge of safe sleep recommendations was not associated with actual parental practices. Trust of and commitment to recommendations were positively correlated with safe sleep position practices. It is essential to develop ethnic-/gender-focused intervention programs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Prevention of early age initiation of cannabis use is a national priority, highlighting the importance of identifying cannabis‐specific attitudes, norms, and perceived behavioral control in relation to initiation age. METHODS: Data were from the NEXT Generation Health Study, a national longitudinal sample of US adolescents followed from 10th grade (N = 1850). Cannabis‐specific attitudes, norms, and perceived behavioral control were assessed at 10th grade. Age of first use was reported retrospectively 2‐3 years after high‐school and participants were categorized as early initiators (<14 years; 3.8%), high‐school (HS) initiators (14‐18 years; 35.6%), post‐HS initiators (>18 years; 8.3%), or never users (52.3%). RESULTS: Relative to never users, early initiators were more likely to endorse pro‐use attitudes (AOR [adjusted odds ratio] = 2.39, 95% confidence interval [CI] = 1.27‐4.50), less disapproving parental attitudes toward use (AOR = 2.50, 95% CI = 1.45‐4.28), higher cannabis use among friends (AOR = 3.81, 95% CI = 2.21‐6.60), and higher ease of access (AOR = 2.10, 95% CI = 1.14‐3.87); HS initiators were similarly more likely to report less disapproving attitudes toward use (AOR = 1.55, 95% CI = 1.25‐1.91), higher cannabis use among friends (AOR = 2.81, 95% CI = 2.18‐3.65), and higher ease of access (AOR = 1.66, 95% CI = 1.21‐2.28). CONCLUSIONS: Earlier cannabis initiation was associated with more favorable cannabis attitudes, subjective norms, and perceived behavioral control, highlight these variables as potential intervention targets. [ABSTRACT FROM AUTHOR]

Background: Opioid use disorder (OUD) affects an estimated 16 million people worldwide. The diagnosis of OUD is commonly delayed or missed altogether. We aimed to test the utility of machine learning in creating a prediction model and algorithm for early diagnosis of OUD. Subjects and methods: We analyzed data gathered in a commercial claim database from January 1, 2006, to December 31, 2018 of 10 million medical insurance claims from 550 000 patient records. We compiled 436 predictor candidates, divided to six feature groups - demographics, chronic conditions, diagnosis and procedures features, medication features, medical costs, and episode counts. We employed the Word2Vec algorithm and the Gradient Boosting trees algorithm for the analysis. Results: The c-statistic for the model was 0.959, with a sensitivity of 0.85 and specificity of 0.882. Positive Predictive Value (PPV) was 0.362 and Negative Predictive Value (NPV) was 0.998. Significant differences between positive OUD- and negative OUD- controls were in the mean annual amount of opioid use days, number of overlaps in opioid prescriptions per year, mean annual opioid prescriptions, and annual benzodiazepine and muscle relaxant prescriptions. Notable differences were the count of intervertebral disc disorder-related complaints per year, post laminectomy syndrome diagnosed per year, and pain disorders diagnosis per year. Significant differences were also found in the episodes and costs categories. Conclusions: The new algorithm offers a mean 14.4 months reduction in time to diagnosis of OUD, at potential saving in further morbidity, medical cost, addictions and mortality. [ABSTRACT FROM AUTHOR]

Objective: Low back pain (LBP) is a very common symptom. It occurs in all age groups from children to the elderly population. Globally, years lived with disability caused by LBP increased by 54% between 1990 and 2015. Our objective was to investigate measures that associate with LBP in students. Participants: A structured, anonymous, self-report questionnaire was distributed in two study years, 2009 and 2015. Participants included 1,026 students, 57.7% of them female, with a mean age of 27.2 (SD = 6.4). Methods: The questionnaire included validated questions on various subjects related to health status and health behaviors. Results: The associated factors of undergraduate students experiencing backaches are higher if they engage in smoking (AOR = 2.15; p<.01), report study-based stress (AOR = 2.39; p<.01), and show depressive symptoms (AOR = 2.69; p<.000). Conclusions: Smoking, stress, and depression are strong measures associated with backache in undergraduate students, significantly more than BMI, physical activity, or sedentary behaviors. [ABSTRACT FROM AUTHOR]

Background: Deviant and health risk behaviors among young-adults are associated with many adverse outcomes. Objectives: This study aims to evaluate a broad variety of behaviors by gender differences and their contribution to predicting cannabis use in undergraduate students. Method: This research is based on a structured, self-reported anonymous questionnaire distributed to 1,432 young adult undergraduate students at an Israeli University, 533 males and 899 females (mean age 27.4; SD 6.01). Results: The findings demonstrate a significant proportion of sampled young adults reported to be involved in deviant and health risk behaviors and that all risky behaviors were more frequently significant in males than in females. Among drivers 72% reported speeding, 60% reported failure to keep distance, 44% reported being involved at a car accident as a driver, 40% reported not stopping at a stop sign, and quarter reported driving after drinking alcohol. These findings also expand how certain risk behaviors contribute to predicting cannabis use. Conclusions: The relatively high prevalence of some of these risky behaviors among normative young adults suggests that risky behaviors are considered as normative behavior for this group, especially among man, and therefore, policymakers need to consider prevention and harm reduction interventions relevant to this risk group. [ABSTRACT FROM AUTHOR]

Introduction: The purposes of this study are to characterize Israeli undergraduate students' driving violations in the terms of problem behavior theory and to identify whether there is any relationship between driving violations and health risk behaviors, daring behaviors, excitement seeking, and health promotion behaviors.Methods: This study is based on a structured self-reported anonymous questionnaire distributed to undergraduate students in an academic institution. The sample included 533 undergraduate students (374 females and 159 males). The mean age was 23.4 (SD = 1.4, range = 5).Results: A higher prevalence of self-reported driving violations was found among males in comparison to females. All substance use measures were positively related to driving violations; for example, use of cigarettes (OR = 4.287, P <.001) and water pipes (odds ratio [OR] = 3.000, P <.001) as well as binge drinking (OR = 5.707, P <.001) and regular cannabis smoking (OR = 5.667, P <.001) raise the probability of committing rare driving violations. The strongest predictive factors for the frequent driving violations group were alcohol consumption-related variables: binge drinking (OR = 2.560, P <.01) and drunkenness (OR = 2.284, P <.05). Strong odd ratios were also found between the frequent driving violations group and selling or dealing drugs (12.143, P <.001), and stealing something valuable (13.680, P <.001). The strongest predicted variable for the rare driving violations group was physical confrontation due to verbal disagreement (3.439, P <.05) and the concept that selling or dealing drugs is socially acceptable (2.521, P <.05). The probability of executing rare driving violations was higher for subjects who reported intense physical workout regimens (OR = 1.638, P <.05).Conclusions: Problem behavior theory succeeded in explaining health risk behavior and driving violations. This study shows that bachelors tend to be more involved in risk behaviors, such as substance use, excitement-seeking behaviors, and daring behaviors and are active physically and thus constitute a risk group for driving violations. As such, intervention resources should be directed toward this group. [ABSTRACT FROM AUTHOR]

Background: This study examines the contribution of the Health Management Bachelor's degree program at an Israeli university to the professional development of its graduates. The aims of this study were: To examine the perceived gaps between acquired knowledge and required knowledge within the workforce; To explore the potential changes in the graduates' occupation conditions or professional status following their studies; To test the contribution of the curricula content studied by the graduates to their understanding, knowledge and integration within the healthcare system; and to examine the graduates perceptions towards required content, that should be added to the curricula.Methods: A structured, self-reported questionnaire was administered to 182 Health Management Department individuals whom have graduated from the Bachelors program between the years 2005 and 2009.Results: The majority of the graduates reported the existance of a knowledge gap (greater among males, young and single than among females, older and married graduates). Most of the courses which were ranked as the lowest contributing ones were related to Management (e.g. Mathematics for Social Sciences, Accounting Fundamentals, Finance Theory), while the graduates recommended the inclusion of additional components to the curricula.Conclusions: The study demonstrates that a perceived gap exists between the acquired and the required knowledge of the Health Management Studies graduates. Various changes have been reported by the graduates (such as wage raise and role changes), following their study completion, suggesting that the program has partially contributed to their professional status. A 'Learning by Sharing' forum of academic staff, employers and graduates is recommended. [ABSTRACT FROM AUTHOR]

The current research was designed to examine associations of perceived life threat (PLT) and religious coping with the development of avoidance behavior following terror event exposure. Based upon the terror management theory (TMT), we hypothesized that religious coping, through its effect on religious beliefs as a meaning system, would moderate the impact of threat, as expressed in PLT, on an individual's reaction to terror event exposure, as manifested in avoidance behavior. Participants were 591 Israeli Jewish students who were vicariously or directly exposed to a terror event in the past. We report a significant interaction between PLT and negative religious coping. PLT was positively associated with avoidance behavior but this relationship was more profound among persons who reported high negative religious coping. Secular students reported higher rates of avoidance behavior and negative religious coping and were more likely than religious students to report intrapersonal religious conflict. Our findings suggest that terror event exposure is associated with an elevated sense of threat, which is, at least in part, associated with a weakening of prior religious beliefs. [ABSTRACT FROM AUTHOR]

Religiosity has been shown to moderate the negative effects of traumatic event experiences. The current study was deigned to examine the relationship between post-traumatic stress (PTS) following traumatic event exposure; world assumptions defined as basic cognitive schemas regarding the world; and self and religious coping conceptualized as drawing on religious beliefs and practices for understanding and dealing with life stressors. This study examined 777 Israeli undergraduate students who completed several questionnaires which sampled individual world assumptions and religious coping in addition to measuring PTS, as manifested by the PTSD check list. Results indicate that positive religious coping was significantly associated with more positive world assumptions, while negative religious coping was significantly associated with more negative world assumptions. Additionally, negative world assumptions were significantly associated with more avoidance symptoms, while reporting higher rates of traumatic event exposure was significantly associated with more hyper-arousal. These findings suggest that religious-related cognitive schemas directly affect world assumptions by creating protective shields that may prevent the negative effects of confronting an extreme negative experience. [ABSTRACT FROM AUTHOR]

Purpose: This study examines health perceptions, self and body image, physical exercise and nutrition among undergraduate students. Methods: A structured, self-reported questionnaire was administered to more than 1500 students at a large academic institute in Israel. The study population was heterogenic in both gender and fields of academic study. Results: High correlations between health perceptions, appropriate nutrition, and positive self and body image were found. The relationships between these variables differed between the subpopulation in the sample and the different genders. Engagement in physical exercise contributed to positive body image and positive health perceptions more than engagement in healthy nutrition. Nutrition students reported higher frequencies of positive health perceptions, positive self and body image and higher engagement in physical exercise in comparison to all other students in the sample. Conclusions: This study suggests, as have many before, that successful health promotion policy should reflect a collectivist rather than an individualist ethos by providing health prerequisites through a public policy of health-promotion, where the academic settings support a healthy lifestyle policy, by increasing availability of a healthy, nutritious and varied menu in the cafeterias, and offering students various activities that enhance healthy eating and exercise. Implications and contribution: This study examined health perceptions, self-image, physical exercise and nutrition among undergraduate students and found high correlations between these topics. Nutrition students reported higher frequencies of positive health perceptions, and positive self and body image and engaged more in physical exercise when compared with all other students in the sample. [ABSTRACT FROM AUTHOR]

The goals of this study were to examine the development of affective and behavioral changes following exposure to traumatic events among Israeli students studying under a high level of terror event exposure and to assess the effects of religiosity on those changes development. A questionnaire was administered to 770 students in the Ariel University Center in Judea and Samaria. Higher levels of terror exposure were associated with higher levels of avoidance behavior, subjective feelings of insecurity, and emotional distress. Higher religiosity moderated avoidance behavior, even when controlling for the level of objective exposure to terror events exposure, but had no influence on subjective sense of insecurity, or the level of emotional distress. These findings suggest that religiosity moderates behavioral changes development after traumatic event exposure mainly by reducing avoidance behavior. [ABSTRACT FROM AUTHOR]

Background: This study examined the effectiveness of a birth preparation course on coping with childbirth among primigravid ultra-orthodox Jewish women in Israel. Methods: In total, 130 ultra-orthodox 25–35-week primigravid women were divided into a study (n = 100, participated in birth preparation courses) and a control (n = 30, did not participate in the courses) group. A questionnaire was delivered three times: T1—before the course/delivery, T2—two–three days after delivery, and T3—a month after delivery. Results: At T3, self-efficacy among the study group was higher than in the control group. Differences in self-efficacy were found over time regardless of the group (F(2,246) = 12.83, p < 0.001), as a time–group interaction effect (F(2,246) = 10.20, p < 0.01). Self-efficacy in the study group (Mean, M = 3.40, Standard deviation, SD = 0.63 at T1) dropped to M = 3.06, SD = 0.76 at T2 and rose to M = 3.34, SD = 0.64 at T3. In the control group, self-efficacy (M = 3.53, SD = 0.56 at T1) dropped to M = 3.26, SD = 0.63 at T2 and to M = 2.95, SD = 0.76 at T3. Discussion: The childbirth preparation course was found to be effective in raising self-efficacy among primigravid ultra-orthodox religious women when compared to the control group. [ABSTRACT FROM AUTHOR]

Background: Patient satisfaction with the quality of health care services is complex with many known factors impacting upon satisfaction, among them the choice of physician. Previous studies examined characteristics of a woman's choice of gynecologist, but information regarding reasons for these choices among women of Ethiopian descent is lacking. The objective of this study was to identify characteristics related preference of an obstetrician-gynecologist based on gender among women of Ethiopian descent. Method: Analysis of anonymous self-reported questionnaire distributed to 500 women of Ethiopian descent who visited an obstetrician-gynecologist at least once in the past three years (Mean age 29.5; SD = 8.2). Trust in physician was examined using the TPS scale; service quality was checked using the SERVQUAL; and the 5Qs model was used to measure patient's satisfaction of health care. Results: Very religious (84.1%) and religious (53.6%) women of Ethiopian descent were more likely to prefer a female obstetrician-gynecologist compared to traditional (39.3%) or secular (34.4%) women (p < 0.001). Participants had higher probability to prefer a male gynecologist if they had more employment hours (OR = 3.57, 95% CI = 1.72–7.42, p < 0.001), and the responsiveness of the physician was less important to them (OR = 0.77, 95% CI = 0.60–0.99, p < 0.05). Age of participants, country of birth, years in Israel, family status, being a mother, education or health status were not associated with choosing a female obstetrician-gynecologist. Religious women would prefer to wait longer for a female gynecologist due to modesty imperatives, even at the cost of compromising their health as a result of waiting longer. Conclusions: The findings of this research highlight the importance of accessibility to female obstetrician-gynecologists for women of Ethiopian descent and demonstrate that determinants in the host population rather than immigrant's past culture, affect the women's decision. This study demonstrates the importance of the health care system in Israel to enable more female obstetrician-gynecologists to treat women of Ethiopian descent. [ABSTRACT FROM AUTHOR]

Background: End stage renal disease (ESRD) describes the most severe stage of chronic kidney disease (CKD), when patients need dialysis or renal transplant. There is often a delay in recognizing, diagnosing, and treating the various etiologies of CKD. The objective of the present study was to employ machine learning algorithms to develop a prediction model for progression to ESRD based on a large-scale multidimensional database.Methods: This study analyzed 10,000,000 medical insurance claims from 550,000 patient records using a commercial health insurance database. Inclusion criteria were patients over the age of 18 diagnosed with CKD Stages 1-4. We compiled 240 predictor candidates, divided into six feature groups: demographics, chronic conditions, diagnosis and procedure features, medication features, medical costs, and episode counts. We used a feature embedding method based on implementation of the Word2Vec algorithm to further capture temporal information for the three main components of the data: diagnosis, procedures, and medications. For the analysis, we used the gradient boosting tree algorithm (XGBoost implementation).Results: The C-statistic for the model was 0.93 [(0.916-0.943) 95% confidence interval], with a sensitivity of 0.715 and specificity of 0.958. Positive Predictive Value (PPV) was 0.517, and Negative Predictive Value (NPV) was 0.981. For the top 1 percentile of patients identified by our model, the PPV was 1.0. In addition, for the top 5 percentile of patients identified by our model, the PPV was 0.71. All the results above were tested on the test data only, and the threshold used to obtain these results was 0.1. Notable features contributing to the model were chronic heart and ischemic heart disease as a comorbidity, patient age, and number of hypertensive crisis events.Conclusions: When a patient is approaching the threshold of ESRD risk, a warning message can be sent electronically to the physician, who will initiate a referral for a nephrology consultation to ensure an investigation to hasten the establishment of a diagnosis and initiate management and therapy when appropriate. [ABSTRACT FROM AUTHOR]