Shoulder osteoarthritis treatment in 441 Orthopedic surgery clinics in Europe

CARDIOLOGY: I was told to call about the results of the examination ... I have been calling sporadically for 3 months (including 10 calls in a row) unfortunately without success They will evaluate the results of examinations, e.g. 10 patients and the nurse should be obliged to pick up the phone and call everyone - work for 15 min I don't know if it is more convenient for them to sit there with the phones ringing all day

OK

Partner ProCare.

Good day, thank God, I had to request the services of RZP 3 times already. Twice they came from a joke, but that's simply not worth commenting on!!! Deep below the level!!! Neská is 1 November 2023 at around 12 noon. And I need them again! And they came, but from Galanta! Those people from RZP are really professionals! Nice friendly and PROFESSIONAL !!! DIAGNOSIS FOR TWO COINS !!! GENTLEMEN, THANK YOU!!!

Today my father was discharged from the internal ward for a pulmonary embolism. What he experienced there with the cleaners is simply unfathomable. Rude, arrogant, humanity means nothing to them. They raised their voices at the patients, ran into the room in the morning with such a roar, with the intention of waking them up, and even when that didn't help, they shouted at my father that hey hey hey we're building. My father, who is seriously ill on the devices, should have been sober and not put up with such inappropriate behavior of the cleaning ladies. It seems that they consider themselves to be of a higher caste, because what they allow themselves to do to patients is unparalleled. Unfortunately, they spoil the good name of the hospital. Someone competent should sort things out with them and order a course in empathy and, above all, decent behavior.

I am extremely dissatisfied with the emergency room staff and especially with the approach of the nurses. My son had a coughing fit, I rang the bell about 5 times and no one answered. After 20 minutes, the nurse came out and was quite unpleasant. It would probably be possible to complete training on empathy towards patients and family members. . I don't even want to imagine what would happen if a patient came here with a bloody injury. Apparently, he could also bleed out here, since the bell is only there to be when no one responds to it.

If someone reads this comment, please share it. And let them send an inspection there, today I saw how a nurse put a pillow on a little babe's face when he was lying5 on his back in the children's ward in the new village of Spiš, that's it's unbelievable what is being done there.

I would like to thank the neurologist for the examinations and treatment. departments. I have not seen such a great attitude of the doctors and all the staff of the inpatient neurological department towards the patient for a long time. Thank you from the heart.

I would like to thank my mother, a 77-year-old blind patient, for the examination at the gynecology department on the evening of September 18, 2023, for the wonderful and humane approach of Mr. MUDr. Unfortunately, I do not know the name of Okály and the nurse. I have not seen such a great approach to a patient for a long time. Thank you from the heart.

It's a shame that the hospital associates with doctors like Dr. Katarína Szentesiová. Seeing the effort to change, but doctors like Dr. For every step Szentesi takes the hospital forward, the next three steps back. The arrogant approach and the investigation from a distance of 5-6 meters, from a chair, only underline the sentence: it is better to die than to go to the emergency room in Dunajská Streda. One such doctor is enough, and all the others who do their work with an interest in the patient and his health have no chance to convince a disappointed patient. It's a real shame, the whole hospital. She might look special, but she will never be like this...

An unknown number of people wait for a CT scan at the orthopedic clinic. I couldn't do it even after two days and 7.5 hours of waiting. There is total chaos here during the reception of patients. It's the worst hospital I've ever experienced in my life, they don't deserve a single star... I HIGHLY DO NOT RECOMMEND

Kind staff but the place is in extreme need of reconstruction

Something shocking, in the corridor in front of everyone they ask you the questions you filled in the questionnaire (!?) intimate, private and about your health... the examination is normal... and at the end the nurse in the corridor in a glass booth shouts your name and your results!!!!!shock

The center as such is excellently equipped, the premises are nice. Receptionist and nurses very nice. I was struck by the attitude of the primary lady, who was obviously in a bad mood. A person will come there with respect from the examination and there is no need to add his bad mood. Instructing me that why am I here when nothing is wrong with me is rather strange, as my gynecologist seems to know why she sent me there. On the one hand, we call women to prevention and when you get there, what are you here for.

Even though it is a hospital, every time I go there I leave pleasantly pleased and surprised by how kindly, respectfully and professionally the patient is taken care of. Thank you for your services and for raising the level of health care to a higher level. 👌

I wish you a good day. In June 2023, our 89-year-old mother was operated on in your hospital. She was operated on by Mudr. Turčan, Mr. Prime Minister of the private gynecologist. Mamma center in BB. He performed the operation in an absolutely professional manner, for which we thank him very much. My mother, but also the family, were very worried about putting her to sleep, as she has a very weak heart and, of course, her old age. She was anesthetized by the head of the OAIM department, Mudr. Paľúch Štefan, who did his job absolutely professionally. After the operation, he gave us the necessary information, assured and reassured us that my mother was transferred to the ward in a stable condition, where he took the initiative to check her. In this way, I want to sincerely thank him for our family and my mother for everything he did for her, for his fantastic care and spiritual support. We thank the entire medical staff for exemplary care. With thanks and respect, Anna Ľuptáková and her family and mother Emília Machavová.

I sincerely thank the Surgical Department - Hospital Agel Žiar nad Hronom. I met incredibly nice medical staff in the department, helpful, smiling, without any signs of nervousness or stress. I also rate the cleanliness of the ward and the food very positively. Although I had a prescribed diet, the dishes were excellently flavored. Special thanks to the mayor MUDr. To Ján Grolmus for his human approach and urgent solution to my health problem. I left the hospital after 4 days with the feeling that the patients in the glowing surgical department are in the best hands of professionals who do not lack empathy.

I'm on the neurol. department super access p. Dr. Kamilka Turek, she does everything possible, but the pain can't work miracles and the blockage is not over, the nurses are also ok, but the diet is still a lactose-free diet, and if it happens to them, one Max two days, but not every day, cottage cheese, yogurt, cheese, butter, dill sauce... shake

"internal" Some patients are tied to the bed. They don't give them anything to drink, eat, anything... they give the patients crap... this hospital is a death factory. On the day of discharge, when the patients are supposed to go home, they are fine in the morning, but in the afternoon they are unrecognizable when picked up. After discharge, in the report, they are supposed to give home medicine equipment for the patient for 3 days....they give empty containers. Apparently, this is how the insurance company makes money... the hospital charges for something it doesn't even give. At the time of the spread of the coronavirus, no nurse even uses a mask and in the isolation room where there is covid I do not use protective suits... now I also caught covid from the hospital. If I don't have empathy and feeling for people.....get the hell out of the job! You might get away with it now....but karma.....it works....one day you will also be lying on your shoulder blades and begging for help...

What is a surgical emergency when they tell the patient why he came... especially that he is in a lot of pain.... and the next time they also take the patient away just to make them feel better?

It's a complete disaster, under no circumstances can you get into the internment because everyone has you on the hook, I lay there and every day someone died next to me who came because there was no examination, they pricked his vein, infusion, sevas, the end of care, they brought him breakfast, he didn't eat, they took away, then they sent and took away lunch, they didn't deal with it the poor guy doesn't know how to feed himself, he was completely hooked, he grunted there all night until he died! Now my old woman went to the toilet, her head was spinning, she wanted to grab the nurse, and she swerved and fell, oh my god, and these stinkers are crying for wages, I wouldn't even give them minimum wage for their performance, even an illiterate can do it there, Saturday is the meat processing plant, never there don't send a grandparent because they treat them like manure and I'm not kidding, they can't even detect streptococcus, those amateurs, I'd rather die at home than go there, believe me

The worst hospital in the world, shame, you can be ashamed of me, we have a mother hospitalized there for a long time, and my mother complains that I beat her there, the nurses have no idea 😑😑😑😬

I have to agree with most of what has been said here about the OdCH ward primary, as we have been to this ward far too many times over the past three years, we have had the opportunity to experience her condescending behavior first hand. This person really does not belong in healthcare.

Allow me to draw your attention to the experiences that we, as a family, experienced in the Department of Adult Diseases (ODCH) in Rožnav, under the leadership of Dr. Dovalova. I am writing to you with a sense of sadness and deep concern because we have lost two beloved members of our family in this institution in the last year. In the first case, it was about our grandmother, who was already in advanced age and her state of health was unstable. This fact is understandable in our perception, but the second case hurts us immensely. Recently, here in this department, a young patient from our family died suddenly, without warning and without a clear explanation. We leave these experiences with a lot of unanswered questions. Despite our repeated attempts to get answers and clarity from the hospital management and Dr. Dovalova, we were ignored. At a time when we would have expected empathy and transparency, we were met with reluctance and silence. I would therefore like to express my concern and warn other families. Trust in medical professionals is key, but it is important to remember that we have a right to be informed and to demand answers. Do not ignore any doubts or ambiguities that may arise about the health status of your loved ones. Please, if you find yourself in a similar situation, don't play with fire. If you have suspicions or misunderstandings, do not hesitate to contact the relevant authorities. In moments of unexpected loss of a beloved family member, we must not be silenced. Please keep us in your prayers and thank you in advance for your support and understanding during this difficult time.

Well, I was lying in the surgical ward after a rather demanding operation, but I have never experienced such an approach, the doctors were willing, kind, they constantly checked us 3 times a day, and the primary doctor Kyslan one topka, thank you very much, nurses? nurses like there should be helpful everywhere , nice, willing to help if you just close the window, friendly, communicative, but the bomb and the nurses were your top... sensitively treat wounds, help, joke... the cleanliness of the ward, the food is a bit worse, but that's in every hospital. I hope that I will never have to undergo any surgery, but if by any chance I would go there again, and I am from KE, where I do not have good experience, and basically, the rests that were done to me at the KE hospital were put together with willingness and high expertise. Thank you Anka

Greetings... I want to thank the staff of the Internal Department. also to the staff of the Geriatrics Department, who treated and cared for my mother Mária Gubova until she left for the Lord..... She is now well. Once again..... Many thanks, daughter Anna Sklenčárová, Medzilaborce

To begin with, I want to give credit to the doctors and other staff who want to help and care in this hospital, but I want to point out the other side of people who just go to work a shift. Access to patients is at freezing point. Getting information about the patient (family), what kind of health problem he has, how to proceed with the treatment, how to help him is difficult, you'll rather win at sports. Calling competent people is an art, with the result that you have to come in person, and it is still doubtful whether you will find someone who is in charge of the patient in question. The family is forced to visit the patient daily and help him if they want him back healthy. It is not for nothing that people go to this hospital to die. The hospital is in urgent need of reconstruction, so that the staff can work better, but the patients can rest. If I can advise, immediately take the patient somewhere else, even though it would cost money, which is not equal to the health of the loved one (patient).

In 2 days, they managed to turn a normal person into a wreck ... 1st class hyenism towards old people ... ICU department - doctor and staff serving on the night of 14.9. on 15.9 in cooperation with the internal department.

Disaster, they put me in a non-smoking room with pneumonia, someone stole my expensive medicine and they dragged me around the hospital even though everything hurts and I can't even walk, I had to walk over 700m and no one helped me even to wrap my arms around me. And I'm not talking about the fact that the maintenance man gaped at me, allegedly that I turned off my oxygen... I would be very interested in how I turned off my oxygen when I can't even lift my arm. Well, just completely wrong, never again.

Reluctant staff doctors even worse. They talk her out of Covid, which has been gone for a long time... They deny the parents information about the child. Only one parent is allowed in the clinic. I have never experienced this anywhere and I go all over Europe.

Meskanie

Hm.

Super

I was in the one-day surgery department for 4 days because I had a more complicated operation. Many nurses took turns with me and I cannot say a word about their care and willingness. Everyone was nice, helpful and smiling. The food was beyond expectations, chicken schnitzel, steamed buns, gnocchi with meat, of course jam, butter, honey, rolls or fruit. Thank you for the procedure and for the care. I am glad that I chose the second district for the operation.

Today, October 3, 2023, it was supposed to be vaccinated to protect health against covid 19. From 1:00 p.m., approx. 40 people who registered were supposed to be vaccinated, and from 2:00 p.m., it was their turn to come unregistered. Topoľčany hospital was unprepared (one nurse and one doctor, the system did not work). Most of the registered people were elderly people. At 1:30 p.m., the nurse and the doctor started to deal with something... The two of us came from Prievidza and were unregistered. After 14.00 we left with the fact that we have a chance to get in line in 3-4 hours, as 2-3 people were vaccinated before our departure. In a word, chaos. We gave up. But before we left, we spoke to the deputy at the directorate, who, with her incompetence, only stated that the doctor could not keep up. It is possible that such incompetent people work in hospital management. We traveled 60 km there and 60 back and nothing. We will see when and where we manage to get vaccinated. Sincerely, Maja Krpelanová

The professional, humane approach of the entire gynecology department during the entire hospitalization, dear nurses, thank you very much to Drs. Kereková and Szabová for my operation, my gynecologist praised the excellent sewing when pulling out the stitches.

Shock, nurse, one, second, third.....receptionist, unpleasant, important, reluctantly, the right hand does not know what the left hand is doing, they think that all patients are from BB. So they exaggerate you unnecessarily, because it doesn't matter to them, never again!!!!

Today's experience On September 10, 2023, we brought my uncle to the Department of Vascular Surgery. 11.9. they are going to operate on him in the morning. The experience happened when the nurses were admitting him to the room, one of them said come, you can go, because it was visiting hours and there were two of us with him, we wanted to unpack him in the room, but when I was walking through the corridor, there was a shout, where are we supposed to go? That we are supposed to go to Kaufland..., I don't understand, one says she can and the other is a rude, disgusting woman, I can't call her a nurse. How to treat relatives of patients? How serious? I'm a psychologist and I can't afford to treat people like this, to anyone. This has nothing to look for in a hospital, you need to communicate tactfully and work with humility in hospitals. It's sad, you want to help your relatives, right? I just wanted to carry my bag and you are blamed for it in the hospital, where that understanding should not be missing.

Super

My experience is like that - quick and easy!

Registration desk - 1st floor. Messy, reluctant, rude and arrogant, one after another, all who registered me in several days. You should consider a replacement, it's not just my experience. To discourage you at the first contact in the hospital... all wrong!

It's a fashion in the hospital that all the staff talk about everything and especially as loudly as possible... the cleaners argue about who has what to do and actually nobody does anything. I deliberately watched the peroxide-blonde disheveled lady washing the floor with one wet rag, the entire entrance hall... after a minute she came back complaining that people had stepped on her. Professionalism is disappearing everywhere.

I flew in from Denmark to enjoy the services of this perfect clinic..services, care simply all for 11 points out of 10 possible thank you very much again..you are amazing..Mudr.Krajcovic, Mudr.Mraz, Marek, Michaela and others 👏👏👏

Long story short 🙂: I had a couple of surgeries on both hip joints when I was one year old. Everything went well at that time, living with the thought that the problem was solved forever, enjoying the outdoor activities I wanted to do. But I was wrong. The day when I started feeling pain in my right hip joint which has also reflected on my walking mobility was the life challenge I didn't ask for. It was not the way I was imaging my life further, pills were not helping a lot, the only way out was the surgery (hip replacement). As I am not Slovak, at first it was hard for me to decide where to do it, here or go home, you know so many things to take into consideration including the care after surgery especially if you do not have any family member beside you. I did search on net and found this clinic which took my attention as potential one based on all the info and patient testimonials I read. Fortunately, the orthopedist MUDr. Jozef Vojtaššák, PhD who did all my examinations advised me that this is the clinic where he is performing the surgeries. And actually this was the decisive piece for my dilemma. Today, after 15 days from the successful surgery I am happy that I feel the difference and for this nice feeling I would like sincerely to thank MUDr. Jozef Vojtaššák, PhD for his professional and caring approach, for all his support, advises and answers to my million questions, to all nurses and physiotherapists from the Clinica Orthopedica and Spine Clinic for their unconditional care, patience, friendly approach and kindness who made my two weeks stay in the clinic like home.Looking back now, it was maybe fast but definitely right decision to make, not regretting at all, thankful and grateful to the whole medical team who has for sure overachieved my expectations. Life is beautiful, more beautiful without pain, pills, sleepless nights...Wishing you many other successful stories from your future patients, satisfied patients who will replace the pain with happiness and smile on their faces as I did and will continue to enjoy the life with an excitement, experiencing new safe, painless walking adventures. My deepest Thank You & Warm Regards! All the Best, Elena (MK).

Excellent clinic, very professional, very well organized. My wife had a serious knee injury, surgery seemed to be inescapable, but the doctor made the utmost to avoid it, excellent diagnostic, took time to look into it and decision taken to go the conservative way. Very good physiotherapy, follow up incl. MR and all well today. Big THANKS to the team!!

Avoid the hospital as far as you can! A congregation of butchers, inhuman herds! (Respect for the exception, but there aren't many of them...) It's a shame that such people can work in the hospital in Komárom! The person who wants to be cured comes out in a much worse condition than when he went in!

Today the house was at the emergency room. Dr. Štefan Ollé treated me. Absolute satisfaction, explanation, diagnostics, human approach. Thank you❤

Those who work in surgery should be ashamed of themselves. Care is worth nothing. My grandmother is lying in the dirt, the sheet is pure blood and disinfectant, the blood is smeared on her hands. Completely dried out, his mouth is on a pot, he can't get up, he can't drink, they don't even look at them for hours. When I ask the general practitioner, the patient doesn't even know who it is until I show it to him, and even then he just blurts out something and leaves, and I don't have time to ask. My mom was amortized in a week. And unfortunately, it's not the first such experience. This is anything but a hospital!!!!!!

Opinion on private family natural birth. Premium package. It was my second birth. The first one was at Medeor Hospital in Łódź, which I remember much better even though I didn't pay for it. There I experienced warmth, respect and understanding that was often lacking here. I went to the hospital after 6 hours of painful contractions with severe pain. I was seen by a doctor who from the very beginning called me "you", treating me with contempt. I don't remember his name, but I think he introduced himself as Marek (I think it was Dr. Marek Korożan, but I could be wrong because 2 years have passed since the birth). Based on the CTG results, he said that I was not giving birth at all, but since I had already come from far away, I should go to the antenatal room and go to sleep, and that I would definitely not give birth in the near future. At the very beginning, I felt like an intruder and a bother of four letters. I spent several hours in the room with my husband - of course, not sleeping and fighting contractions. After a few hours, a midwife (Ms. Joanna Miłosz) came and asked if I should be examined. I agreed. It turned out that I was 6 cm dilated and they asked if I should give anesthesia. I remember the midwife fondly. The anesthesiologist was also very nice and tried to relax the atmosphere while administering anesthesia. Morning came and with it a change of staff. Another gynecologist was very cold and unpleasant. When the anesthesia was removed and I started to complain about my statement that it hurts, I heard that I had pain when I was lying under anesthesia, and now it doesn't hurt at all, so I shouldn't say that because it's not true :-) Childbirth after anesthesia lying down despite my willingness and strength to give birth in a vertical position. While pushing, I heard some sarcastic and embarrassing comments from this lady (I unfortunately didn't remember her name). I felt very uncomfortable. Even on the National Health Fund, I have never been treated so disrespectfully and unpleasantly. When complications occurred, fortunately Dr. Chmyłko and Dr. Wnuk came and alleviated the unpleasant atmosphere. The birth was difficult and had complications, but thanks to them I felt cared for and safe at that moment. I also remember the doctor fondly. med. Anna Lew-Tusk - a neonatologist who took great care of our daughter when it turned out that her test results were not good. Postpartum care was generally okay, but despite my high temperature (infection) and the baby crying all night, I was not offered to take the baby so I could rest. Despite the completed birth plan and my clear objection to it, an injection of vitamin K was administered, later claiming it was by mistake. Other objective facts: comfortable beds, nice maternity room, good food. Due to complications for me and my daughter, we stayed in the ward a few days longer and I did not pay anything extra for this. My memories of giving birth are rather unpleasant. I paid for a private birth to avoid unpleasant situations and give birth in harmony with myself - my expectations were definitely not met. I wouldn't choose to give birth at Swissmed again.

Last week I had a planned CC in Swissmed - breech position. I am very pleased with my choice, the medical staff was very nice, everyone answered my questions, doubts and explained them. My husband was able to be with me during the surgery, after the surgery the care was also very good, the midwives and neonatal nurses were very helpful, kind and understanding. The doctors were also very nice and patient. I recommend

Doctors nice and competent however ladies on the phone rude and not helpful… they instruct you before you even explain what is the problem and have ZERO understanding and patience for family of patients. we paid for the test we did not get results on, trying to get through to the doctor on the phone- impossible. I do not recommend this hospital unfortunately due to poor customer service.

My opinion about the Golden Care Clinic is five :-) The receptionists are very polite and inform us exactly what we want to know before the tests. There are often situations when a patient cancels an appointment and we have the opportunity to schedule tests sooner. The doctors examine everything we have doubts about very carefully, are very polite and help us with a sincere smile. You must remember that the Golden Care Clinic is a private clinic, I recommend that you always ask carefully after the examination about medications, allergic conditions, the course of the disease, methods and duration of treatment. This will prevent stress, bad comments and more money spent. I recommend.

The staff first postpones the visit to an earlier time (which forces me to change my plans) and then it turns out that there is another delay. Moreover, loudly informing the patient about additionally paid tests during the visit in a full waiting room is not very comfortable.

Quiet, peaceful - no crowds, no shouting or rushing. Great employees - positive attitude towards the patient, ready to help (greetings to the receptionist from 19/10/23, very nice and helpful, and to the nurse ;)

I was with my child in the hospital due to a procedure under general anesthesia. Starting with the receptionists: nice, helpful and professional. Admission to the ward went smoothly, nurses provided exemplary care. The ladies had a great approach to the child and their behavior significantly reduced the stress of the child and the parent before the procedure. The preparation for anesthesia itself was well organized - the parent could be with the child until the last possible moment before entering the operating room and immediately after the patient woke up. The food is very good - a variety of breakfasts and dinners (vegetables, cold meats, cheese, yogurt, etc.) and enough for both children and parents. Doctors are patient, helpful and cordial. I give it a well-deserved 5 - the child only shed tears before leaving - that it's over and it's time to part with the new friend from the room :)

The appointment was made for a specific time of 2:20 p.m., but on arrival it turns out that the doctor is not there yet and it is not known when he will be there. A queue of 10 people, some with an appointment for the same time. No information from the clinic about the situation before arrival. I asked for a refund, if someone doesn't have time to wait 3 hours for their turn, I don't recommend it.

Although I only had an MRI in this hospital, I had a really positive impression. Everyone is very nice :) the hospital makes an impression, everyone should look like that. And most importantly, the deadline very soon (and on the National Health Fund)

In May 2022, we urgently arrived from Kazakhstan to the clinic. It was necessary to install a drainage to remove bile from the liver. The condition was quite serious, bilirubin was more than 500 units. In Kazakhstan it was not possible to install drainage, it did not work. Ivan Mikhailovich Davydov did an excellent job with this complex operation, many thanks to him and the clinic for this. Excellent care, modern equipment, competent, experienced doctors.

At the beginning of August, I underwent a full check-up at the NACFF clinic. I really liked the clinic, the level of high professionalism of all the doctors. I especially want to express my gratitude to the therapist Pashayeva Zhavgar Magomedrasulovna. Despite her young age, Zhavgar Magomedrasulovna is a professional in her field and helps resolve all issues related to my health! A very sensitive and responsible specialist. Good luck, development and prosperity to the NACFF clinic!!!

A good clinic, competent doctors, I really liked Nelegach Tatyana Vladimirovna. Competent professional, patient and very polite. He tells everything on the shelves, a very pleasant person. I also liked the ultrasound specialists, the comfortable atmosphere. The neurologist who did the echocardiography of the heart is very charismatic and attentive. I didn’t really like the gynecologist, Khugaeva, the feeling that I consulted not with a doctor, but in the market) I don’t like gynecologists, it’s difficult for me to have examinations, my body twitches reflexively, that I can’t do anything about it and I have to endure through force. (And I already tried to endure as best I could and lie still) this is when you try to insert lenses into your eyes and the eyelids begin to close themselves. They did a screening of the cervix, I thought I would burn with shame, during the examination, constantly “well, why are you twitching, I don’t hurt, you are having sex, but what’s terrible” post-Soviet attitude entered the chat) inappropriate questions about earnings, etc. ) Most likely, as a specialist, she is really competent, she has gone through so many institutions in her practice, but her attitude towards patients should be improved. In general, the hospital is good, I recommend. Their only disadvantage is poor management, and untimely approval of preliminary plans and estimates. The price tag is adequate, but if you go through a check, prepare for the amount not 110,000, but from 130,000 (if you are about 20 years old) and from 250,000 if you are about 60. Passed 3 times checkup, me, husband and grandmother. And they did an operation to reduce the grandmother's breasts, we are waiting for the results) Doctors - 5 out of 5 Atmosphere - 5 out of 5 Management - 3 out of 5 Politeness - 5 out of 5 Patience - 4 out of 5 Value / quality - 4 out of 5