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Objective: To evaluate the risk factors for a negative birth experience using the Birth Satisfaction Scale‐Revised (BSS‐R) questionnaire. Methods: A cross‐sectional study including women who gave birth at a single tertiary hospital between February 2021 and January 1, 2022. Birth satisfaction was measured using the BSS‐R questionnaire. Maternal, pregnancy, and delivery characteristics were collected. Negative birth experience was defined as a BSS‐R score lower than the median. Multivariable regression analysis was used to examine the association between birth characteristics and negative birth experience. Results: A total of 1495 women answered the questionnaire and were included in the analysis; 779 women comprised the positive birth experience group and 716 women comprised the negative birth experience group. Prior deliveries, prior abortions, and smoking (adjusted odds ratio [aOR], 0.52 [95% confidence interval (CI), 0.41–0.66]; aOR, 0.78 [95% CI, 0.62–0.99]; aOR, 0.52 [95% CI, 0.27–0.99], respectively) were independently associated with lower risk of negative birth experience. Immigration, answering the questionnaires in person, and cesarean delivery were independently associated with increased negative birth experience risk (aOR, 1.39 [95% CI, 1.01–1.86]; aOR 1.37 [95% CI, 1.04–1.79]; aOR, 1.92 [95% CI, 1.52–2.41], respectively). Conclusion: Parity, prior abortions, and smoking were associated with a lower risk of negative birth experience, while immigration, answering questionnaires in person, and cesarean delivery were associated with a higher risk of negative birth experience. Synopsis: Risk factors for a negative birth experience using the Birth Satisfaction Scale‐Revised (BSS‐R) include parity, prior abortions, immigrant status, answering the questionnaire in person, and cesarean delivery. [ABSTRACT FROM AUTHOR]

Background The coronavirus 2019 (COVID-19) pandemic affected health-care systems worldwide, leading to fewer admissions and raising concerns about the quality of care. The objective of this study was to investigate the early effects of the COVID-19 pandemic on quality of care among stroke and ST-elevation myocardial infarction (STEMI) patients, focusing on clinical outcomes and direct treatment costs. Method This retrospective, observational study was based on the 10-week period that included the first wave of the COVID-19 pandemic in Israel (15 February 2020–30 April 2020). Emergency department admissions for stroke and STEMI were compared with parallel periods in 2017–2019, focusing on demographics, risk and severity scores, and the effect of clinical outcomes on hospitalization costs. Results The 634 stroke and 186 STEMI cases comprised 16% and 19% fewer admissions, respectively, compared to 2019. No significant changes were detected in demographics, most disease management parameters, readmission and mortality outcomes. The mean door-to-balloon time increased insignificantly by 33%, lowering the health quality indicator (HQI) for treatment in <90 min from 94.7% in 2017–2019 to 83% in 2020 (P  = 0.022). Among suspected stroke patients, 97.2% underwent imaging, with 28% longer median time from admission (P  = 0.05). Consequently, only 24.3% met the HQI of imaging in <29 min, compared to 45.5% in 2017–2019 (P  < 0.01). Increased length of stay and more intensive care unit admissions were the leading causes of 6.5% increased mean cost of STEMI patients' initial hospitalization, which totaled $29 300 in the COVID-19 period (P  = 0.008). Conclusion The initial pandemic period caused a decline in HQIs linked to diagnostic and treatment protocols, without changes in outcomes, but with increased hospitalization costs. Medical information and awareness of life-threatening conditions among patients and caregivers should be increased to enable proper diagnosis and management. [ABSTRACT FROM AUTHOR]

The poem "My Self Defense" by Alex Galper, translated from the Russian by Igor Satanovsky and Mike Magazinnik, is presented. First Line: I am eating delicious borsht to protest wolfish capitalism; Last Line: Allow gays to get married or I am ordering a cappuccino with cream.

Patient-reported outcomes measure patients' views of their health-related quality of life. With the increasing interest and usage of PRO's in the world, Sheba Medical Center is the pioneer in the field in Israel looking at the potential value in PRO implementation in routine practice as a quality improvement tool together with the opportunity to help drive changes in healthcare delivery. The PRO implementation process involves the multi-disciplinary ward or clinic staff in order to engage them and transform the process into a work routine. The collection methods and usage differ from one clinical area to another and require cultural adaptation in each area. Adjusted reporting and usage during patient encounter assist to improve patient enrolment and provide better and more accurate outcomes for the patient and the medical center.